Individual
DR. JODI MICHELLE CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
1375 E 19TH AVE, DENVER, CO 80218-1114
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0056362
CO
207P00000X
Emergency Medicine Physician
60141
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027028
KAISER COMMERCIAL NUMBER
CO
05
—
1942434006
—
WI
Enumeration date
05/05/2009
Last updated
06/19/2021
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