Provider Demographics
NPI:1730617192
Name:DO, JIM MINH (MD)
Entity type:Individual
Prefix:DR
First Name:JIM
Middle Name:MINH
Last Name:DO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1190 US HIGHWAY 287
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-7021
Mailing Address - Country:US
Mailing Address - Phone:303-544-3800
Mailing Address - Fax:303-544-3810
Practice Address - Street 1:1190 US HIGHWAY 287
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-7021
Practice Address - Country:US
Practice Address - Phone:303-544-3800
Practice Address - Fax:303-544-3810
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0064352207Q00000X
COTL0006807207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO029069OtherKAISER COMMERCIAL NUMBER
CO9000157946Medicaid