Healthcare Provider Details

I. General information

NPI: 1962539924
Provider Name (Legal Business Name): JEFFREY L CUNNINGHAM MDA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 FRANKLIN ST ACUTE ORTHOPEDICS, 4TH FLOOR
DENVER CO
80205-5437
US

IV. Provider business mailing address

2045 FRANKLIN ST ACUTE ORTHOPEDICS, FOURTH FLOOR, EAST
DENVER CO
80205-5437
US

V. Phone/Fax

Practice location:
  • Phone: 303-861-3408
  • Fax:
Mailing address:
  • Phone: 303-861-3412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: