Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | POD.0000689 | CO |
NPI | 1043419492 |
---|---|
Provider Name | Dr. Jared L Overman |
First Address | Fort Collins, CO 80526-1833 |
Second Address | Fort Collins, CO 80526-1833 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2007 |
Last Update Date | 24/01/2019 |