Drew, Jack M

Drew, Jack M is an individual health care provider with primary practice located at 1400 E Boulder St , Colorado Springs CO 80909-5533. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Drew, Jack M can be contacted via phone (719) 365-5853.

Contact Information

Primary practice address
1400 E Boulder St Colorado Springs CO 80909-5533
Phone: (719) 365-5853
Fax: (719) 365-1048
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X DR.0051824 Colorado

Profile Details

NPI number 1255321014
LBN Legal business name Drew, Jack M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2005
Last updated Oct 5th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255321014 NPPES
Colorado MEDICAID 24275069

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