Provider Demographics
NPI:1821093501
Name:ERICKSON, JON MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:MICHAEL
Last Name:ERICKSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:500 DISCOVERY PKWY
Mailing Address - Street 2:STE 125
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-8639
Mailing Address - Country:US
Mailing Address - Phone:303-926-8734
Mailing Address - Fax:303-926-8747
Practice Address - Street 1:500 DISCOVERY PKWY
Practice Address - Street 2:STE 125
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-8639
Practice Address - Country:US
Practice Address - Phone:303-926-8734
Practice Address - Fax:303-926-8747
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO33524207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery