Provider Demographics
NPI:1699852970
Name:JACOBS, JANA L (DO)
Entity Type:Individual
Prefix:DR
First Name:JANA
Middle Name:L
Last Name:JACOBS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 SHEA CENTER DR STE 301
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2251
Mailing Address - Country:US
Mailing Address - Phone:303-357-2559
Mailing Address - Fax:
Practice Address - Street 1:19641 E PARKER SQUARE DRIVE
Practice Address - Street 2:SUITE E
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134
Practice Address - Country:US
Practice Address - Phone:303-805-2222
Practice Address - Fax:303-805-2255
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2018-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35903207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01359033Medicaid
COJA60362OtherBCBS
CO501338Medicare PIN
COF67089Medicare UPIN
COJA60362OtherBCBS