Healthcare Provider Details

I. General information

NPI: 1275596652
Provider Name (Legal Business Name): JILL MARIE SOHAYDA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JILL MARIE HAUNHORST MD

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8555 W BELLEVIEW AVE STE A06
LITTLETON CO
80123-7307
US

IV. Provider business mailing address

96 WILLOWLEAF DR
LITTLETON CO
80127-3582
US

V. Phone/Fax

Practice location:
  • Phone: 303-973-3683
  • Fax: 855-852-7674
Mailing address:
  • Phone: 720-933-2297
  • Fax: 855-852-7674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number38688
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number38688
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: