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Individual

JASON TRUMAN GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1024 S LEMAY AVE, FORT COLLINS, CO 80524-3929
(303) 306-7783
(303) 306-7753
Mailing address
PO BOX 912215, DENVER, CO 80291-2215
(303) 306-7783
(303) 306-7753

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
43340
CO
207P00000X
Emergency Medicine Physician
IL036-110752
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01976818
CO
05
121920100
WY
Enumeration date
02/07/2006
Last updated
05/13/2014
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