Individual
JOSEPH P JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 BENEDICTA AVE, TRINIDAD, CO 81082-2089
(719) 846-2206
Mailing address
400 BENEDICTA AVE, TRINIDAD, CO 81082-2089
(719) 846-2206
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26122
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01261221
—
CO
Enumeration date
05/03/2006
Last updated
03/26/2012
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