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Individual

DR. JONATHAN RAY DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
4110 BRIARGATE PKWY STE 405, COLORADO SPRINGS, CO 80920-7838
(719) 365-7300
(719) 365-7301
Mailing address
1650 COCHRANE CIR, COLORADO SPRINGS, CO 80913-4613
(719) 524-2410

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
2016-01799
NC
2084N0400X
Neurology Physician
2023047856
MO
2084N0400X
Neurology Physician
338240
LA
2084N0400X
Neurology Physician
Primary
DR.0062521
CO
2084N0400X
Neurology Physician
OS19628
FL
208D00000X
General Practice Physician
1014
WA

Other

Enumeration date
05/16/2011
Last updated
01/02/2024
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