Basic Information
| Provider Information | |||||||||
| NPI: | 1265525711 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JANASEK | ||||||||
| FirstName: | MITCHELL | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 758 PIONEER PL | ||||||||
| Address2: | |||||||||
| City: | WINDSOR | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805505954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9704200358 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1230 14TH ST SW | ||||||||
| Address2: | |||||||||
| City: | LOVELAND | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805376324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9706193999 | ||||||||
| FaxNumber: | 9706193997 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 10/21/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 38936 | CO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.