Provider Demographics
NPI:1528396728
Name:OZEZER, SELIN
Entity Type:Individual
Prefix:
First Name:SELIN
Middle Name:
Last Name:OZEZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SELIN
Other - Middle Name:
Other - Last Name:OZEZER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 173862
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-3862
Mailing Address - Country:US
Mailing Address - Phone:303-306-7101
Mailing Address - Fax:303-306-7753
Practice Address - Street 1:1719 E 19TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1235
Practice Address - Country:US
Practice Address - Phone:303-839-7111
Practice Address - Fax:303-306-7753
Is Sole Proprietor?:No
Enumeration Date:2009-11-27
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATMA052242363A00000X
COPA.0004407363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant