Provider Demographics
NPI:1508889874
Name:JAMELL, GARY ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:ALAN
Last Name:JAMELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3601 S CLARKSON ST
Mailing Address - Street 2:SUITE #120
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3944
Mailing Address - Country:US
Mailing Address - Phone:303-781-4008
Mailing Address - Fax:303-781-6923
Practice Address - Street 1:3601 S CLARKSON ST
Practice Address - Street 2:SUITE #120
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3944
Practice Address - Country:US
Practice Address - Phone:303-781-4008
Practice Address - Fax:303-781-6923
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2008-05-09
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Provider Licenses
StateLicense IDTaxonomies
CO32286207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G06314Medicare UPIN
COCA7628Medicare PIN