Provider Demographics
NPI:1386687390
Name:AMMONS, JOHN TIMOTHY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:TIMOTHY
Last Name:AMMONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1666 S UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-2853
Mailing Address - Country:US
Mailing Address - Phone:303-320-1777
Mailing Address - Fax:303-733-9219
Practice Address - Street 1:1666 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-2853
Practice Address - Country:US
Practice Address - Phone:303-320-1777
Practice Address - Fax:303-733-9219
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32139207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF60448Medicare UPIN
CO72088Medicare ID - Type Unspecified