Bacon, Jeffrey Lance

Bacon, Jeffrey Lance is an individual health care provider with primary practice located at 615 Fairhurst St , Sterling CO 80751-4564. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bacon, Jeffrey Lance can be contacted via phone (970) 521-3223.

Contact Information

Primary practice address
615 Fairhurst St Sterling CO 80751-4564
Phone: (970) 521-3223
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 38444 Colorado

Profile Details

NPI number 1255391132
LBN Legal business name Bacon, Jeffrey Lance
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Mar 18th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255391132 NPPES
Colorado MEDICAID 95304789

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