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Individual

DR. JACK L SHARON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2222 N NEVADA AVE, COLORADO SPRINGS, CO 80907-6819
(719) 766-5333
(719) 766-5651
Mailing address
2222 N NEVADA AVE, ATTN: FRONT RANGE EMERGENCY SPECIALISTS, COLORADO SPRINGS, CO 80907-6819
(719) 475-0299
(719) 475-0414

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
33591
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01335918
CO
01
930106279
RR MEDICARE
CO
Enumeration date
05/08/2006
Last updated
12/03/2012
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