Provider Demographics
NPI:1518033307
Name:BLOOR, JOHN HOLT (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HOLT
Last Name:BLOOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8727 E KETTLE PL
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2710
Mailing Address - Country:US
Mailing Address - Phone:720-529-5942
Mailing Address - Fax:303-771-7554
Practice Address - Street 1:8727 E KETTLE PL
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2710
Practice Address - Country:US
Practice Address - Phone:720-529-5942
Practice Address - Fax:303-771-7554
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO29353207RG0100X, 207RI0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Not Answered207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01329143Medicaid
COF33652Medicare UPIN
COD11394Medicare ID - Type Unspecified