Provider Demographics
NPI:1194706267
Name:JAVIER, JANETTE LORENA S (MD)
Entity type:Individual
Prefix:
First Name:JANETTE LORENA
Middle Name:S
Last Name:JAVIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANETTE LORENA
Other - Middle Name:S
Other - Last Name:JAVIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:373 E 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:81073-1699
Mailing Address - Country:US
Mailing Address - Phone:719-523-4501
Mailing Address - Fax:719-523-4290
Practice Address - Street 1:900 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:CO
Practice Address - Zip Code:81073-1636
Practice Address - Country:US
Practice Address - Phone:719-523-6628
Practice Address - Fax:719-523-4290
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42267207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODR 42267OtherCO LICENSE NUMBER