Organization
JONATHAN BLACKER MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN E BLACKER M.D. (OWNER)
(303) 795-3443
Entity
Organization
Contact information
Practice address
8000 E. PRENTICE AVENUE, SUITE D-12, GREENWOOD VILLAGE, CO 80111-2744
(303) 795-3443
(303) 290-6317
Mailing address
8000 E. PRENTICE AVENUE, SUITE D-12, GREENWOOD VILLAGE, CO 80111-2744
(303) 795-3443
(303) 290-6317
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
27023
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01270230
—
CO
Enumeration date
09/24/2009
Last updated
07/21/2010
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