Provider Demographics
NPI:1790745867
Name:APFELBAUM, JONATHAN (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:APFELBAUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 W MINERAL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-5685
Mailing Address - Country:US
Mailing Address - Phone:303-759-0854
Mailing Address - Fax:303-759-0864
Practice Address - Street 1:7700 S BROADWAY
Practice Address - Street 2:LITTLETON ADVENTIST HOSPITAL - EMERGENCY DEPARTMENT
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2602
Practice Address - Country:US
Practice Address - Phone:303-730-5800
Practice Address - Fax:303-730-5868
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4852911-1205207PE0004X, 207P00000X
CO34899207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTD4279Medicaid
CO01348994Medicaid
UT005568324Medicare ID - Type Unspecified3460 PIONEER PKWY, WVC
UT005568524Medicare ID - Type Unspecified630 MEDICAL DR, BOUNTIFUL
UTD4279Medicaid
UT005567216Medicare ID - Type Unspecified5475 S. 500 E, OGDEN
UT005568418Medicare ID - Type Unspecified3580 W 9000 S, W JORDAN
UT005568621Medicare ID - Type Unspecified1050 E. SOUTH TEMPLE, SLC
CO01348994Medicaid
COCO301135Medicare PIN