1447336268 NPI number — JEFFREY R GAPPA D.C.

Table of content: JEFFREY R GAPPA D.C. (NPI 1447336268)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447336268 NPI number — JEFFREY R GAPPA D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GAPPA
Provider First Name:
JEFFREY
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447336268
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
606 S 4TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRIGHTON
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80601-3202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-659-0805
Provider Business Mailing Address Fax Number:
303-659-2676

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
606 S 4TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRIGHTON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80601-3202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-659-0805
Provider Business Practice Location Address Fax Number:
303-659-2676
Provider Enumeration Date:
10/27/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111NS0005X , with the licence number:  3285 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: M12340 . This is a "WORKERS COMPENSATION" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".