Provider Demographics
NPI:1770618332
Name:RIESBERG, JAMIE C (MD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:C
Last Name:RIESBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2505 ROSSMERE ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-4869
Mailing Address - Country:US
Mailing Address - Phone:719-524-1740
Mailing Address - Fax:
Practice Address - Street 1:2767 JANITELL RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4102
Practice Address - Country:US
Practice Address - Phone:719-365-2888
Practice Address - Fax:719-365-1577
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43292207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine