MEDICARE: DR. JAMIE LYNN STALKER M.D.

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	036-082283	IL

General Provider Information

NPI Number	:	1912165861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMIE LYNN STALKER M.D.

Provider Business Mailing Address
First Line	:	9950 W 80TH AVE STE 17
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80005-3914
Country	:	US
Telephone Number	:	303-423-9585
Fax Number	:	303-421-0777

Provider Business Practice Location Address
First Line	:	9950 W 80TH AVE STE 17
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80005-3914
Country	:	US
Telephone Number	:	303-423-9585
Fax Number	:	303-421-0777

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

Provider Enumeration Date	:	05/28/2008
Last Update Date	:	08/09/2021

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