Jay L Adler, MD

Individual provider Active NPI Family Medicine Physician · Colorado Springs, CO

NPI 1659360238 · NPPES record last updated Aug 6, 2012

Key facts

NPI
1659360238
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
22818 (CO)
Practice address
2 S Cascade Ave
Suite140
Colorado Springs, CO 80903-1624
Phone
(719) 538-2950
Fax
(719) 538-2996
NPI assigned
Oct 17, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22818COMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22818 CO Yes

Addresses

Primary practice location

2 S Cascade Ave
Suite140
Colorado Springs, CO 80903-1624

Mailing address

2220 West Colorado Ave
Colorado Springs, CO 80903-1604
Phone (719) 473-6306

Other identifiers

IdentifierTypeStateIssuer
01228188MedicaidCO

Other providers in Colorado Springs, CO

All providers in Colorado Springs, CO · Family Medicine Physician in Colorado

Sources for this page

Verify at the official NPI Registry.