Provider Demographics
NPI:1881695195
Name:SOLLENDER, JONATHAN LEE (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:LEE
Last Name:SOLLENDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1411 S POTOMAC ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4536
Mailing Address - Country:US
Mailing Address - Phone:303-695-4369
Mailing Address - Fax:303-695-4649
Practice Address - Street 1:1411 S POTOMAC ST
Practice Address - Street 2:SUITE 310
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4536
Practice Address - Country:US
Practice Address - Phone:303-695-4369
Practice Address - Fax:303-695-4649
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO41043208200000X, 2082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO41043OtherMEDICAL LICENSE
G38301Medicare UPIN