Healthcare Provider Details

I. General information

NPI: 1497720494
Provider Name (Legal Business Name): JULES ROSEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 10/24/2023
Certification Date: 10/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 PEAK ONE DRIVE STE 110
FRISCO CO
80443
US

IV. Provider business mailing address

PO BOX 2257
BRECKENRIDGE CO
80424-2237
US

V. Phone/Fax

Practice location:
  • Phone: 970-668-3478
  • Fax: 970-668-0632
Mailing address:
  • Phone: 970-318-7033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number52523
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number52523
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: