Provider Demographics
NPI:1093824229
Name:GILTNER, JAMES B (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:B
Last Name:GILTNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 GARDEN CTR
Mailing Address - Street 2:STE 100
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-7026
Mailing Address - Country:US
Mailing Address - Phone:303-469-1941
Mailing Address - Fax:303-339-6251
Practice Address - Street 1:1485 S COLORADO BLVD
Practice Address - Street 2:#220
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3619
Practice Address - Country:US
Practice Address - Phone:303-839-7878
Practice Address - Fax:303-759-9375
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO25404207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01254044Medicaid
C46627Medicare UPIN
CO01254044Medicaid