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Individual

JAN G DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1600 N GRAND AVE, SUITE 230, PUEBLO, CO 81003-2730
(719) 595-7260
(719) 595-7265
Mailing address
1600 N GRAND AVE, SUITE 230, PUEBLO, CO 81003-2730
(719) 595-7260
(719) 595-7265

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
30574
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01305747
CO
Enumeration date
06/28/2006
Last updated
07/09/2014
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