Provider Demographics
NPI:1114246972
Name:JEFFREY J KREBS, DO, PC
Entity Type:Organization
Organization Name:JEFFREY J KREBS, DO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:J
Authorized Official - Last Name:KREBS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:970-249-9678
Mailing Address - Street 1:5 HILLCREST PLAZA WAY
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-5876
Mailing Address - Country:US
Mailing Address - Phone:970-249-9678
Mailing Address - Fax:970-249-1868
Practice Address - Street 1:5 HILLCREST PLAZA WAY
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5876
Practice Address - Country:US
Practice Address - Phone:970-249-9678
Practice Address - Fax:970-249-1868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-19
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO28091207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COD25041Medicare UPIN
COC50641Medicare PIN