Healthcare Provider Details
I. General information
NPI: 1194570754
Provider Name (Legal Business Name): JARED JOSHUA ANUCHA BARNETT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/18/2024
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12600 ALBROOK DR
DENVER CO
80239-4604
US
IV. Provider business mailing address
4862 N CAMINO DE LA CODORNIZ
TUCSON AZ
85745-9711
US
V. Phone/Fax
- Phone: 303-602-4000
- Fax:
- Phone: 520-907-3860
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | TL.0010361 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: