| Dr Kathleen A Daetwyler, MD | |
| 10240 Park Meadows Dr, Lone Tree, CO 80124-5425 | |
| (303) 338-4545 | |
| Not Available | 
| Full Name | Dr Kathleen A Daetwyler | 
|---|---|
| Gender | Female | 
| Speciality | Anesthesiology | 
| Location | 10240 Park Meadows Dr, Lone Tree, Colorado | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1134352818 | NPI | - | NPPES | 
| 026021 | Other | CO | KAISER COMMERCIAL NUMBER | 
| 70053235 | Medicaid | CO | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207L00000X | Anesthesiology | BC5174494-374 (Massachusetts) | Secondary | 
| 207L00000X | Anesthesiology | 0054867 (Colorado) | Primary | 
| Entity Name | Colorado Permanente Medical Group Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1760599724 PECOS PAC ID: 1254238454 Enrollment ID: O20031216000640 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Kathleen A Daetwyler, MD 10350 E Dakota Ave, Denver, CO 80247-1314 Ph: () - | Dr Kathleen A Daetwyler, MD 10240 Park Meadows Dr, Lone Tree, CO 80124-5425 Ph: (303) 338-4545 | 
| Dr. Stacey Lynn Warner, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 9777 S Yosemite St Ste 210, Lone Tree, CO 80124 Phone: 303-708-2943 | |
| Dr. Ryan Robert Wilson, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 10240 Park Meadows Dr, Lone Tree, CO 80124 Phone: 303-338-4545 | |
| Dr. Jefferson P Mostellar, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 10240 Park Meadows Dr, Lone Tree, CO 80124 Phone: 303-338-4545 | |
| Long D Vu, D.O. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 10375 Park Meadows Dr Ste 270, Lone Tree, CO 80124 Phone: 303-351-5995 Fax: 720-925-5897 | |
| Dr. Kelly O'hear Sheppard, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 10240 Park Meadows Dr, Lone Tree, CO 80124 Phone: 303-338-4545 | |
| Melissa Pelkey, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 10099 Ridgegate Pkwy Ste 200, Lone Tree, CO 80124 Phone: 720-225-4466 |