Healthcare Provider Details

I. General information

NPI: 1811922339
Provider Name (Legal Business Name): RAJESH JAIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 06/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 W COLFAX AVE STE B
LAKEWOOD CO
80214-5434
US

IV. Provider business mailing address

10403 W COLFAX AVE STE 630
LAKEWOOD CO
80215-3812
US

V. Phone/Fax

Practice location:
  • Phone: 303-573-9951
  • Fax: 303-573-1013
Mailing address:
  • Phone: 303-205-1090
  • Fax: 303-205-1120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number37888
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: