Healthcare Provider Details

I. General information

NPI: 1932225356
Provider Name (Legal Business Name): JASON CHRISTOPHER KALAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 03/07/2023
Certification Date: 12/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6190 BARNES RD
COLORADO SPRINGS CO
80922-2600
US

IV. Provider business mailing address

6190 BARNES RD
COLORADO SPRINGS CO
80922-2600
US

V. Phone/Fax

Practice location:
  • Phone: 719-596-4502
  • Fax: 719-598-8020
Mailing address:
  • Phone: 719-596-4502
  • Fax: 719-598-8020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number9475A
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number72612
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number43123
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: