Healthcare Provider Details

I. General information

NPI: 1548408743
Provider Name (Legal Business Name): JASON WRIGHT, MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2009
Last Update Date: 01/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3340 WESTERDOLL AVE
LOVELAND CO
80538-7255
US

IV. Provider business mailing address

1175 58TH AVE STE 202
GREELEY CO
80634-4808
US

V. Phone/Fax

Practice location:
  • Phone: 970-461-8888
  • Fax:
Mailing address:
  • Phone: 970-495-0300
  • Fax: 970-224-9624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JASON WRIGHT
Title or Position: OWNER
Credential: MD
Phone: 970-461-8888