Healthcare Provider Details

I. General information

NPI: 1134588650
Provider Name (Legal Business Name): JEFFREY BARON AU.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2016
Last Update Date: 02/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 W 120TH AVE STE 214
DENVER CO
80234-2713
US

IV. Provider business mailing address

1001 W 120TH AVE STE 214
DENVER CO
80234-2713
US

V. Phone/Fax

Practice location:
  • Phone: 720-749-3152
  • Fax:
Mailing address:
  • Phone: 720-749-3152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number0000014
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number0000014
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: