Provider Demographics
NPI:1356525828
Name:JOHN SCHULTZ MD PC
Entity type:Organization
Organization Name:JOHN SCHULTZ MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-861-7001
Mailing Address - Street 1:1601 E 19TH AVE
Mailing Address - Street 2:SUITE 3700
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1216
Mailing Address - Country:US
Mailing Address - Phone:303-861-7001
Mailing Address - Fax:303-861-8624
Practice Address - Street 1:1601 E 19TH AVE
Practice Address - Street 2:SUITE 3700
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1216
Practice Address - Country:US
Practice Address - Phone:303-861-7001
Practice Address - Fax:303-861-8624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31983207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO70770051Medicaid
CO38184OtherANTHEM PROVIDER NO.
CO38184OtherANTHEM PROVIDER NO.
COE98207Medicare UPIN