Provider Demographics
NPI:1386733756
Name:JONES, JULIE ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANNE
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:ANNE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3095 FENNO DR
Mailing Address - Street 2:
Mailing Address - City:CORDILLERA
Mailing Address - State:CO
Mailing Address - Zip Code:81632-6090
Mailing Address - Country:US
Mailing Address - Phone:970-569-3839
Mailing Address - Fax:970-569-3839
Practice Address - Street 1:3095 FENNO DR
Practice Address - Street 2:
Practice Address - City:CORDILLERA
Practice Address - State:CO
Practice Address - Zip Code:81632-6090
Practice Address - Country:US
Practice Address - Phone:970-569-3839
Practice Address - Fax:970-569-3839
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4127208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
C17620Medicare UPIN
TX89H280Medicare PIN