1770548067 NPI number — DR. JEAN M GREOS M.D.

Table of content: DR. JEAN M GREOS M.D. (NPI 1770548067)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770548067 NPI number — DR. JEAN M GREOS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GREOS
Provider First Name:
JEAN
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1770548067
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/22/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
701 E HAMPDEN AVE
Provider Second Line Business Mailing Address:
SUITE 350
Provider Business Mailing Address City Name:
ENGLEWOOD
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80113-2736
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-788-6490
Provider Business Mailing Address Fax Number:
303-788-5451

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
701 E HAMPDEN AVE
Provider Second Line Business Practice Location Address:
SUITE 350
Provider Business Practice Location Address City Name:
ENGLEWOOD
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80113-2736
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-788-6490
Provider Business Practice Location Address Fax Number:
303-788-5451
Provider Enumeration Date:
04/19/2006

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: 207R00000X , with the licence number:  28145 , 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: GR45688 . This is a "ANTHEM BLUECROSS/BLUE SHI" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 0134806 . This is a "CIGNA HEALTH CARE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 01281450 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0803395 . This is a "AETNA HEALTH CARE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 110216592 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 84143817902 . This is a "PACIFICARE OF COLORADO" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com