Basic Information
| Provider Information | |||||||||
| NPI: | 1023166345 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KOROTKIN | ||||||||
| FirstName: | ARTHUR | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1725 E PROSPECT RD | ||||||||
| Address2: | |||||||||
| City: | FORT COLLINS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805251307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702212222 | ||||||||
| FaxNumber: | 9702214286 | ||||||||
| Practice Location | |||||||||
| Address1: | 1725 E PROSPECT RD | ||||||||
| Address2: | |||||||||
| City: | FORT COLLINS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805251307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702212222 | ||||||||
| FaxNumber: | 9702214286 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2007 | ||||||||
| LastUpdateDate: | 12/03/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | A90950 | CA | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 45574 | CO | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.