Provider Demographics
NPI:1841258704
Name:STAHL, JAN HARRIS (MD)
Entity type:Individual
Prefix:DR
First Name:JAN
Middle Name:HARRIS
Last Name:STAHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:13772 DENVER WEST PKWY
Mailing Address - Street 2:BLDG#55 STE#100
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3139
Mailing Address - Country:US
Mailing Address - Phone:303-279-6600
Mailing Address - Fax:
Practice Address - Street 1:13772 DENVER WEST PKWY
Practice Address - Street 2:BLDG#55 STE#100
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-3139
Practice Address - Country:US
Practice Address - Phone:303-279-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO31047207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO180020563OtherRAILROAD MEDICARE
CO04007241Medicaid
COK2878OtherMEDICARE LEGACY
K2808Medicare ID - Type Unspecified
CO04007241Medicaid