Provider Demographics
NPI:1922083310
Name:JANSSEN, MICHAEL E (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:JANSSEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9005 GRANT ST
Mailing Address - Street 2:# 200
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4300
Mailing Address - Country:US
Mailing Address - Phone:303-287-2800
Mailing Address - Fax:303-287-7357
Practice Address - Street 1:9005 GRANT ST
Practice Address - Street 2:# 200
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4300
Practice Address - Country:US
Practice Address - Phone:303-287-2800
Practice Address - Fax:303-287-7357
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO30753207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01307537Medicaid
COE81346Medicare UPIN
COC4918Medicare ID - Type Unspecified