Doctor Name: | JONATHAN LEWIS SAXE |
NPI Number: | 1871606475 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHYSICIAN ASSISTANT |
License Number: | |
Business Practice Address: | Normandy Dr. Bldg 7672 Ft Riley, KS - 66448 |
Business Phone Number: | 7852391779 |
Business Fax Number: | |
Mailing Address: | 7867 Renegade Hill Dr, COLORADO SPRINGS |
State: | CO |
Postal Code: | 809233573 |
Phone Number: | 7854772455 |
Fax Number: | |
NPI Enumeration Date: | 08/16/2006 |
NPI Last Update Date: | 03/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |