Individual
JACOB F ELIASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1650 COCHRANE CIR, FORT CARSON, CO 80913-4613
(719) 526-7000
Mailing address
1650 COCHRANE CIR, FORT CARSON, CO 80913-4613
(719) 526-7000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101272235
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/31/2019
Last updated
08/02/2023
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