MEDICARE: DR. JORDAN JAY KARLITZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	202358	LA
2	207RG0100X	Gastroenterology Physician	DR.0065775	CO

General Provider Information

NPI Number	:	1043266349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORDAN JAY KARLITZ MD

Provider Business Mailing Address
First Line	:	PO BOX 110429
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80042-0429
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	660 BANNOCK ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-4506
Country	:	US
Telephone Number	:	720-848-0000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	09/30/2021

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