Individual
KIERAN M JAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 E STAR CT A, MONTROSE, CO 81401-6701
(970) 249-4321
(970) 249-2339
Mailing address
611 E STAR CT A, MONTROSE, CO 81401-6701
(970) 249-4321
(970) 249-2339
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
31910
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01319102
—
CO
01
—
31910
LICENCE
CO
01
—
P00324337
PALMETTA GBA RAILROAD MED
CO
Enumeration date
05/04/2006
Last updated
03/07/2008
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