Peter Jay Ienatsch in Peterson Afb - Physician Assistant
Peter Jay Ienatsch - NPI 1679608038
Peter Jay Ienatsch is a Physician Assistant in Peterson Afb, Colorado. Peter Jay Ienatsch practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Peter Jay Ienatsch is 1679608038. The last update date is 2018-03-30.
Peter Jay Ienatsch's current location address is 559 Vincent St Bldg 959, Peterson Afb, Colorado. You can contact this provider via phone number 7195561306 and fax number 7195561226. The mailing address for Peter Jay Ienatsch is 559 Vincent St Bldg 959, Peterson Afb, Colorado. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Peter Jay Ienatsch |
|---|---|
| Address | 559 Vincent St Bldg 959, Peterson Afb, Colorado |
| Phone Number | 7195561306 |
| Fax Number | 7195561226 |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1679608038 |
|---|---|
| Provider Enumeration Date | 2007-02-23 |
| Last Updated Date | 2018-03-30 |
Provider Mailing Address Detail
| Address | 559 Vincent St Bldg 959 |
|---|---|
| City | Peterson Afb |
| State | Colorado (CO) |
| Post Code | 809141541 |
| Phone Number | 7195561306 |
| Fax Number | 7195561226 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA05044 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| PA0004947 | CO | COLORADO MEDICAL BOARD | |
| PA05044 | TX | TX LICENSE |
Post Comment/ Review Below
What is the Peter Jay Ienatsch's unique identification number?
The Peter Jay Ienatsch has been assigned the NPI (National Provider Identifier) Number 1679608038 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical address where Peter Jay Ienatsch is geographically located?
The Peter Jay Ienatsch is physically situated at the following location: 559 Vincent St Bldg 959, Peterson Afb, CO, 809141541.
What is Peter Jay Ienatsch's specialized field of practice, and what is the corresponding taxonomy classification code?
The Peter Jay Ienatsch's area of specialization is Physician Assistant, and the corresponding taxonomy code that categorizes this field of practice is 363A00000X.
On what date did the Peter Jay Ienatsch receive its 1679608038 assignment from the Centers for Medicare & Medicaid Services?
The Peter Jay Ienatsch was assigned its 1679608038 by the Centers for Medicare & Medicaid Services on 2007-02-23.
When was the information regarding Peter Jay Ienatsch most recently updated?
The details pertaining to the Peter Jay Ienatsch, including its address, specialty, and other relevant information, were last refreshed on 2018-03-30.
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