Healthcare Provider Details

I. General information

NPI: 1518033307
Provider Name (Legal Business Name): JOHN HOLT BLOOR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8727 E KETTLE PL
CENTENNIAL CO
80112-2710
US

IV. Provider business mailing address

8727 E KETTLE PL
CENTENNIAL CO
80112-2710
US

V. Phone/Fax

Practice location:
  • Phone: 720-529-5942
  • Fax: 303-771-7554
Mailing address:
  • Phone: 720-529-5942
  • Fax: 303-771-7554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number29353
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number29353
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: