Provider Demographics
NPI:1275596652
Name:SOHAYDA, JILL MARIE (MD)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:MARIE
Last Name:SOHAYDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:MARIE
Other - Last Name:HAUNHORST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:96 WILLOWLEAF DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-3582
Mailing Address - Country:US
Mailing Address - Phone:720-933-2297
Mailing Address - Fax:855-852-7674
Practice Address - Street 1:8555 W BELLEVIEW AVE STE A06
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-7307
Practice Address - Country:US
Practice Address - Phone:303-973-3683
Practice Address - Fax:855-852-7674
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38688208000000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO33239533Medicaid
CO33239533Medicaid
COC808771Medicare PIN
COBS5718119OtherDEA
CO488768Medicare ID - Type Unspecified