Individual
JORGE DAVALOS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 E BOULDER ST, SUITE 700, COLORADO SPRINGS, CO 80909-5533
(719) 635-7172
(719) 444-3759
Mailing address
8890 N UNION BLVD, STE 160, COLORADO SPRINGS, CO 80920-7799
(719) 365-9950
(719) 365-9969
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2005-01066
NC
207RI0011X
Interventional Cardiology Physician
Primary
47345
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
73402541
—
CO
Enumeration date
04/18/2007
Last updated
09/17/2021
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