Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 46413 | CO |
N | 208200000X | Surgeon | D0065253 | MD |
N | 208600000X | Surgeon | D0065253 | MD |
NPI | 1306925482 |
---|---|
Provider Name | Dr. Jason Michael Rovak |
First Address | Englewood, CO 80113-3781 |
Second Address | Englewood, CO 80113-3781 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 13/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
80076246 | (05) | CO |