Provider Demographics
NPI:1861617607
Name:LUITHUK ZIMIK, MD, PC
Entity type:Organization
Organization Name:LUITHUK ZIMIK, MD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MASOTHING
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-659-1042
Mailing Address - Street 1:70 S 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-3703
Mailing Address - Country:US
Mailing Address - Phone:303-659-1042
Mailing Address - Fax:303-659-4571
Practice Address - Street 1:70 S 20TH AVE
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-3703
Practice Address - Country:US
Practice Address - Phone:303-659-1042
Practice Address - Fax:303-659-4571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20021258301173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty