Provider Demographics
NPI:1023058047
Name:GUNTER, JEFFREY ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALAN
Last Name:GUNTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JEFF
Other - Middle Name:ALAN
Other - Last Name:GUNTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2899 N SPEER BLVD
Mailing Address - Street 2:SUITE #301
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-4202
Mailing Address - Country:US
Mailing Address - Phone:303-525-7645
Mailing Address - Fax:
Practice Address - Street 1:2955 VALMONT RD
Practice Address - Street 2:SUITE 210
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1396
Practice Address - Country:US
Practice Address - Phone:303-440-7525
Practice Address - Fax:303-440-4215
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39484207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO40505073Medicaid
CO40505073Medicaid