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General NPI Number Information
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NPI Number | 1659989523
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Entity Type | Individual
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Provider Name | MOHIT JAIN MD
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Gender | Male
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Dates
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Enumeration Date | 07/16/2020
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 2150 STADIUM DR
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City | BOULDER
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State | CO
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Zip | 80309-8304
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Country | US
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Telephone | 720-848-0000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 110429
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City | AURORA
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State | CO
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Zip | 80042-0429
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Country | US
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Telephone |
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Fax |
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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 | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | MT222022
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | DR.0074301
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License Number State | CO
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