Individual
DR. JERRY S MIKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3655 LUTHERAN PKWY, SUITE 201, WHEAT RIDGE, CO 80033-6018
(303) 603-9800
(303) 403-6209
Mailing address
500 ELDORADO BLVD, SUITE 6250, BROOMFIELD, CO 80021-3408
(303) 272-0750
(303) 318-2488
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
25248
CO
207RI0011X
Interventional Cardiology Physician
Primary
25248
CO
207UN0901X
Nuclear Cardiology Physician
25248
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01252485
—
CO
Enumeration date
05/01/2006
Last updated
07/29/2014
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