Provider Demographics
NPI:1073669677
Name:GILLESPIE, ELIZABETH JO (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JO
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:JO
Other - Last Name:EGELHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:660 BANNOCK ST
Mailing Address - Street 2:4TH FLOOR MC 4000
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4506
Mailing Address - Country:US
Mailing Address - Phone:303-602-5011
Mailing Address - Fax:303-602-5056
Practice Address - Street 1:660 BANNOCK ST
Practice Address - Street 2:4TH FLOOR MC 4000
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4506
Practice Address - Country:US
Practice Address - Phone:303-602-5011
Practice Address - Fax:303-602-5056
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2011-0621208M00000X
DCMD040906208M00000X
COTL-2014390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program