Provider Demographics
NPI:1326129461
Name:WHITE, JARED JAMES (DO, PA-C)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:JAMES
Last Name:WHITE
Suffix:
Gender:M
Credentials:DO, PA-C
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Mailing Address - Street 1:4900 S MONACO ST STE 210
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3487
Mailing Address - Country:US
Mailing Address - Phone:303-453-2997
Mailing Address - Fax:303-453-2998
Practice Address - Street 1:9195 GRANT ST STE 120
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4386
Practice Address - Country:US
Practice Address - Phone:303-453-2997
Practice Address - Fax:303-453-2998
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101018188207X00000X
OH34.011200207X00000X
NY008895-1363AM0700X
CODR.0055441207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO10223517Medicaid
CO10223517Medicaid