Individual
JACOB MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13123 E 16TH AVE, AURORA, CO 80045
(720) 777-1234
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
DR.0055431
CO
Other
Enumeration date
04/20/2012
Last updated
07/28/2018
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