Healthcare Provider Details

I. General information

NPI: 1295051811
Provider Name (Legal Business Name): JASPER JOHN HILLHOUSE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2010
Last Update Date: 04/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 EAST KENTUCKY AVENUE
DENVER CO
80246-2570
US

IV. Provider business mailing address

4900 E KENTUCKY AVE
DENVER CO
80246-2365
US

V. Phone/Fax

Practice location:
  • Phone: 303-756-0101
  • Fax:
Mailing address:
  • Phone: 303-756-0101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number52010
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: