Provider Demographics
NPI:1881396596
Name:JACKSON, CAITLIN STEIN (DO)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:STEIN
Last Name:JACKSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 S POTOMAC ST STE 250
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4541
Mailing Address - Country:US
Mailing Address - Phone:720-874-2411
Mailing Address - Fax:
Practice Address - Street 1:1400 S POTOMAC ST STE 250
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4541
Practice Address - Country:US
Practice Address - Phone:720-874-2411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program