Healthcare Provider Details

I. General information

NPI: 1972747020
Provider Name (Legal Business Name): NOLAN JAMES JAEGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2009
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 MEDICAL CENTER PT STE 220
COLORADO SPRINGS CO
80907-5798
US

IV. Provider business mailing address

1625 MEDICAL CENTER PT STE 220
COLORADO SPRINGS CO
80907-5798
US

V. Phone/Fax

Practice location:
  • Phone: 719-364-5080
  • Fax: 719-364-5081
Mailing address:
  • Phone: 719-364-5080
  • Fax: 719-364-5081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberDR.0067075
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: