Provider Demographics
NPI:1245403823
Name:SELL, JASON RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:RICHARD
Last Name:SELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5788
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-5788
Mailing Address - Country:US
Mailing Address - Phone:303-202-1280
Mailing Address - Fax:303-202-1281
Practice Address - Street 1:11600 W 2ND PL
Practice Address - Street 2:ST. ANTHONY HOSPITAL
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1527
Practice Address - Country:US
Practice Address - Phone:720-321-4161
Practice Address - Fax:720-321-4165
Is Sole Proprietor?:No
Enumeration Date:2008-04-03
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ80912207P00000X
CO47757207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO60908572Medicaid
COP00790355OtherRR MEDICARE
AZ803190Medicaid
NE10025360000Medicaid
20326023101OtherPACIFICARE SECURE HORIZONS
NE10025360000Medicaid