Healthcare Provider Details

I. General information

NPI: 1871586412
Provider Name (Legal Business Name): SANJAY JATANA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 07/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 INVERNESS DR E STE 100
ENGLEWOOD CO
80112-5115
US

IV. Provider business mailing address

145 INVERNESS DR E STE 100
ENGLEWOOD CO
80112-5115
US

V. Phone/Fax

Practice location:
  • Phone: 303-697-7463
  • Fax: 303-783-1200
Mailing address:
  • Phone: 303-697-7463
  • Fax: 303-783-1200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number35965
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: