Provider Demographics
NPI:1447410568
Name:MEARS, JESSICA MARION BAER (DO)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARION BAER
Last Name:MEARS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:FRUITA
Mailing Address - State:CO
Mailing Address - Zip Code:81521-0130
Mailing Address - Country:US
Mailing Address - Phone:970-858-2186
Mailing Address - Fax:970-858-2208
Practice Address - Street 1:576 KOKOPELLI BLVD UNIT D-E
Practice Address - Street 2:
Practice Address - City:FRUITA
Practice Address - State:CO
Practice Address - Zip Code:81521-6304
Practice Address - Country:US
Practice Address - Phone:970-858-2590
Practice Address - Fax:970-858-5036
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0052248207R00000X, 207RR0500X
CO52248207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine