Provider Demographics
NPI:1720115454
Name:STUEBNER, JON W (MD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:W
Last Name:STUEBNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-226-6180
Mailing Address - Fax:720-870-1896
Practice Address - Street 1:14000 E. ARAPAHOE ROAD
Practice Address - Street 2:SUITE 380
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-4028
Practice Address - Country:US
Practice Address - Phone:303-226-6180
Practice Address - Fax:720-870-1896
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2019-08-02
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Provider Licenses
StateLicense IDTaxonomies
CO17629207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01176296Medicaid
CO30136253Medicaid
COC495158Medicare PIN
COP00790400Medicare PIN
COD24377Medicare UPIN
CO30136253Medicaid
COCO301671Medicare PIN