Provider Demographics
NPI:1639335821
Name:MOO-YOUNG, JAIME LEIGH (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:LEIGH
Last Name:MOO-YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W 6TH AVE
Mailing Address - Street 2:MC 3251
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-5182
Mailing Address - Country:US
Mailing Address - Phone:303-602-8070
Mailing Address - Fax:303-602-8076
Practice Address - Street 1:301 W 6TH AVE
Practice Address - Street 2:MC 3251
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-5182
Practice Address - Country:US
Practice Address - Phone:303-602-8070
Practice Address - Fax:303-602-8076
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML60019796207R00000X
CO47854207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO029373OtherKAISER COMMERCIAL NUMBER
WA2021801Medicaid
CO59317531Medicaid