Provider Demographics
NPI:1306188123
Name:JEFFREY L HOLTGREWE MD
Entity Type:Organization
Organization Name:JEFFREY L HOLTGREWE MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOLTGREWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-759-3110
Mailing Address - Street 1:2 FOXHILL RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-4923
Mailing Address - Country:US
Mailing Address - Phone:303-759-3110
Mailing Address - Fax:
Practice Address - Street 1:2 FOXHILL RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-4923
Practice Address - Country:US
Practice Address - Phone:303-759-3110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO28681207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty