Provider Demographics
NPI:1871586412
Name:JATANA, SANJAY (MD)
Entity type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:
Last Name:JATANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 INVERNESS DR E STE 100
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-5115
Mailing Address - Country:US
Mailing Address - Phone:303-697-7463
Mailing Address - Fax:303-783-1200
Practice Address - Street 1:145 INVERNESS DR E STE 100
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5115
Practice Address - Country:US
Practice Address - Phone:303-697-7463
Practice Address - Fax:303-783-1200
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35965207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01359652Medicaid
CO01359652Medicaid