Provider Demographics
NPI:1003887126
Name:METZNER, JEFFREY LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LEE
Last Name:METZNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3300 E 1ST AVE
Mailing Address - Street 2:SUITE 590
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5810
Mailing Address - Country:US
Mailing Address - Phone:303-355-6842
Mailing Address - Fax:303-322-2155
Practice Address - Street 1:3300 E 1ST AVE
Practice Address - Street 2:SUITE 590
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5810
Practice Address - Country:US
Practice Address - Phone:303-355-6842
Practice Address - Fax:303-322-2155
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO200072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01200070Medicaid
CO01200070Medicaid
COD23699Medicare UPIN