Provider Demographics
NPI:1710024088
Name:CHACKO, JOB K (MD)
Entity Type:Individual
Prefix:
First Name:JOB
Middle Name:K
Last Name:CHACKO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1601 E. 19TH AVENUE
Mailing Address - Street 2:SUITE 6400
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1216
Mailing Address - Country:US
Mailing Address - Phone:303-839-7200
Mailing Address - Fax:303-839-7229
Practice Address - Street 1:1601 E. 19TH AVENUE
Practice Address - Street 2:SUITE 6400
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1216
Practice Address - Country:US
Practice Address - Phone:303-839-7200
Practice Address - Fax:303-839-7229
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2009-09-16
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Provider Licenses
StateLicense IDTaxonomies
CO404772088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology