Individual
ELIZABETH I JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10400 E ALAMEDA AVE, DENVER, CO 80247-5104
(303) 360-1505
Mailing address
10400 E ALAMEDA AVENUE, DENVER, CO 80247-5199
(303) 338-4545
(303) 360-1464
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125447
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014499
KAISER-COMMERCIAL NUMBER
—
Enumeration date
02/27/2007
Last updated
07/12/2007
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