Individual
MRS. JACLYN CHRISTINE FERTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, 4200 E. 9TH AVE, DENVER, CO 80262-0001
(303) 315-7424
Mailing address
UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, 4200 E. 9TH AVE, DENVER, CO 80262-0001
(303) 315-7424
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
52023
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023462
KAISER COMMERCIAL NUMBER
CO
05
—
48355542
—
CO
Enumeration date
04/03/2008
Last updated
05/05/2021
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