Provider Demographics
NPI:1760472666
Name:MCELWAIN, JEFFREY M (PA-C)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:M
Last Name:MCELWAIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 COLE BLVD.
Mailing Address - Street 2:STE 100
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401
Mailing Address - Country:US
Mailing Address - Phone:303-716-8018
Mailing Address - Fax:303-763-5495
Practice Address - Street 1:2230 S FRASER ST UNIT 1
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-4536
Practice Address - Country:US
Practice Address - Phone:303-341-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0001327363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
970027948OtherTRAVELERS MEDICARE
CO840706945127OtherROCKY MOUNTAIN HEALTH PLA
P23960Medicare UPIN
970027948OtherTRAVELERS MEDICARE