Provider Demographics
NPI:1538219969
Name:KELSALL, DAVID C (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:KELSALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:601 E HAMPDEN AVENUE
Mailing Address - Street 2:SUITE 430
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113
Mailing Address - Country:US
Mailing Address - Phone:303-783-9220
Mailing Address - Fax:303-806-6292
Practice Address - Street 1:601 E HAMPDEN AVENUE
Practice Address - Street 2:SUITE 430
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113
Practice Address - Country:US
Practice Address - Phone:303-783-9220
Practice Address - Fax:303-806-6292
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2020-12-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO28228207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01282284Medicaid
E48186Medicare UPIN
COC476858Medicare PIN