Provider Demographics
NPI:1942399431
Name:KREBS, JEFFREY J (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:J
Last Name:KREBS
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 1:5 HILLCREST PLAZA WAY
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-5876
Mailing Address - Country:US
Mailing Address - Phone:970-249-9678
Mailing Address - Fax:970-249-1868
Practice Address - Street 1:5 HILLCREST PLAZA WAY
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5876
Practice Address - Country:US
Practice Address - Phone:970-249-9678
Practice Address - Fax:970-249-1868
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO28091207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COD25041Medicare UPIN
COC50641Medicare PIN