MEDICARE: DR. CHRISTOPHER SCOTT JETTER DPM

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	213E00000X	Podiatrist	POD.0000936	CO
2	213ES0103X	Foot & Ankle Surgery Podiatrist	110790	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457615064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER SCOTT JETTER DPM

Provider Business Mailing Address
First Line	:	1311 N MILDRED RD
Second Line	:
City	:	CORTEZ
State	:	CO
Zip	:	81321-2231
Country	:	US
Telephone Number	:	970-565-6666
Fax Number	:

Provider Business Practice Location Address
First Line	:	2250 E 42ND AVE
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5202
Country	:	US
Telephone Number	:	907-569-3668
Fax Number	:

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

Provider Enumeration Date	:	06/28/2012
Last Update Date	:	05/18/2026

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