Basic Information
Provider Information
NPI: 1508943788
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JEFFERS
FirstName: JULIE
MiddleName: E
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SMITH
OtherFirstName: JULIE
OtherMiddleName: ERIN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: D.O.
OtherLastNameType: 5
Mailing Information
Address1: 1707 COLE BLVD
Address2: SUITE 100
City: GOLDEN
State: CO
PostalCode: 804013220
CountryCode: US
TelephoneNumber: 3037168013
FaxNumber: 3037635495
Practice Location
Address1: 9695 S YOSEMITE ST
Address2: STE 324
City: LONE TREE
State: CO
PostalCode: 801242888
CountryCode: US
TelephoneNumber: 3037069054
FaxNumber: 3033029799
Other Information
ProviderEnumerationDate: 11/01/2006
LastUpdateDate: 10/04/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X42768COY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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