Provider Demographics
NPI:1316927411
Name:JANATA, ROBERT J (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:JANATA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1750 E KEN PRATT BLVD
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-5311
Mailing Address - Country:US
Mailing Address - Phone:720-718-7000
Mailing Address - Fax:
Practice Address - Street 1:1750 E KEN PRATT BLVD
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80504-5311
Practice Address - Country:US
Practice Address - Phone:720-718-7000
Practice Address - Fax:970-392-2028
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44109207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO87755025Medicaid
CO87755025Medicaid
COI28353Medicare UPIN
COC804555Medicare PIN