Provider Demographics
NPI:1972566107
Name:SAVAGE, JONATHON P (DO)
Entity Type:Individual
Prefix:
First Name:JONATHON
Middle Name:P
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:JONATHON
Other - Middle Name:P
Other - Last Name:SAVAGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:3513 BRIGHTON BLVD STE 481
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80216-3610
Mailing Address - Country:US
Mailing Address - Phone:303-777-6004
Mailing Address - Fax:
Practice Address - Street 1:3513 BRIGHTON BLVD STE 481
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216
Practice Address - Country:US
Practice Address - Phone:720-778-0005
Practice Address - Fax:303-353-0778
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0039446207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO87659247Medicaid
COCE50247Medicare PIN
CO87659247Medicaid