MEDICARE: JENNIFER A MIX DO

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	207R00000X	Internal Medicine Physician	44437	CO

General Provider Information

NPI Number	:	1477631521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER A MIX DO

Provider Business Mailing Address
First Line	:	1720 S BELLAIRE ST STE 700
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-4312
Country	:	US
Telephone Number	:	720-235-7306
Fax Number	:

Provider Business Practice Location Address
First Line	:	1720 S BELLAIRE ST STE 700
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-4312
Country	:	US
Telephone Number	:	720-235-7306
Fax Number	:

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

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	04/04/2024

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Directions to “ JENNIFER A MIX DO” Practice Location

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