Provider Demographics
NPI:1952690513
Name:VOROS, JEREMY J (MD)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:J
Last Name:VOROS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 S GRAPE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1418
Mailing Address - Country:US
Mailing Address - Phone:801-808-9909
Mailing Address - Fax:
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:MAIL CODE 0108
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4507
Practice Address - Country:US
Practice Address - Phone:303-436-7142
Practice Address - Fax:303-436-7541
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CODR.0054097207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO16987322Medicaid
CO024973OtherKAISER COMMERCIAL NUMBER
CO024973OtherKAISER COMMERCIAL NUMBER