Provider Demographics
NPI:1972566107
Name:SAVAGE, JONATHON P (DO)
Entity type:Individual
Prefix:DR
First Name:JONATHON
Middle Name:P
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:JONATHON
Other - Middle Name:P
Other - Last Name:SAVAGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1123 S CORONA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-1703
Mailing Address - Country:US
Mailing Address - Phone:303-777-6004
Mailing Address - Fax:
Practice Address - Street 1:10350 E DAKOTA AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-1314
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0039446207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO029612OtherKAISER COMMERCIAL NUMBER
CO87659247Medicaid
CO87659247Medicaid