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General NPI Number Information
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NPI Number | 1023040011
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Entity Type | Individual
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Provider Name | JENNIFER L LOUCKS M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 09/25/2013
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Provider Practice Location Address
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Address Line | 701 E HAMPDEN AVE STE 410
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City | ENGLEWOOD
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State | CO
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Zip | 80113-2736
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Country | US
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Telephone | 303-788-1312
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Fax | 303-788-1967
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Provider Business Mailing Address
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Address Line | 701 E HAMPDEN AVE STE 410
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City | ENGLEWOOD
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State | CO
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Zip | 80113-2736
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Country | US
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Telephone | 303-788-1312
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Fax | 303-788-1967
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 41330
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License Number State | CO
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