Provider Demographics
NPI:1053331603
Name:FRETWELL, JAMES M (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:FRETWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:205 S MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-1714
Mailing Address - Country:US
Mailing Address - Phone:303-772-6244
Mailing Address - Fax:303-702-1623
Practice Address - Street 1:205 S MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-1714
Practice Address - Country:US
Practice Address - Phone:303-772-6244
Practice Address - Fax:303-702-1623
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35951207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01359512Medicaid
CO01359512Medicaid
CO358518Medicare ID - Type Unspecified