Provider Demographics
NPI:1992789036
Name:MATOUS, JEFFREY VICTOR (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:VICTOR
Last Name:MATOUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:#210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:720-754-4800
Mailing Address - Fax:720-754-4801
Practice Address - Street 1:1800 WILLIAMS ST
Practice Address - Street 2:STE 300
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1238
Practice Address - Country:US
Practice Address - Phone:720-754-4800
Practice Address - Fax:720-754-4801
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2014-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO28753207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025893500Medicaid
NM54420288Medicaid
WY1992789036Medicaid
CO01287531Medicaid
WY117674900Medicaid
KS200606940BMedicaid
NE10025893500Medicaid
WY117674900Medicaid
CO01287531Medicaid
F16339Medicare UPIN
COP00937763Medicare PIN