Provider Demographics
NPI:1871676148
Name:CONLEY, JAROD ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:JAROD
Middle Name:ALEXANDER
Last Name:CONLEY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3586
Mailing Address - Country:US
Mailing Address - Phone:303-440-3000
Mailing Address - Fax:
Practice Address - Street 1:2750 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3586
Practice Address - Country:US
Practice Address - Phone:303-440-3013
Practice Address - Fax:303-440-3178
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007012256207N00000X
CO48544207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO020709OtherKAISER COMMERCIAL NUMBER
CO26028247Medicaid
CO020709OtherKAISER COMMERCIAL NUMBER
CO26028247Medicaid