Provider Demographics
NPI:1679993562
Name:ANDERSON, JESS (DO)
Entity type:Individual
Prefix:
First Name:JESS
Middle Name:
Last Name:ANDERSON
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:PO BOX 1727
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81502-1727
Mailing Address - Country:US
Mailing Address - Phone:970-257-6200
Mailing Address - Fax:970-263-2691
Practice Address - Street 1:688 23 1/2 RD STE 303
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-8904
Practice Address - Country:US
Practice Address - Phone:970-263-2680
Practice Address - Fax:970-263-2684
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-18
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0074494207RP1001X
NE1453207RC0200X
TXT2813207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine