Provider Demographics
NPI:1457512121
Name:MILLS, JONATHAN COMPTON (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:COMPTON
Last Name:MILLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 SUMMIT BLVD UNIT 204
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-8253
Mailing Address - Country:US
Mailing Address - Phone:720-401-2139
Mailing Address - Fax:303-469-4439
Practice Address - Street 1:403 SUMMIT BLVD UNIT 204
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-8253
Practice Address - Country:US
Practice Address - Phone:720-401-2139
Practice Address - Fax:303-469-4439
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008017177207Y00000X
CO51866207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FM3775573OtherDEA