Provider Demographics
NPI:1619361508
Name:ALTREE, JESSICA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MARIE
Last Name:ALTREE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:MCCLURE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4650 SIGNAL TREE DR STE 1200
Mailing Address - Street 2:
Mailing Address - City:TIMNATH
Mailing Address - State:CO
Mailing Address - Zip Code:80547-4908
Mailing Address - Country:US
Mailing Address - Phone:970-237-7415
Mailing Address - Fax:970-237-7420
Practice Address - Street 1:4650 SIGNAL TREE DR STE 1200
Practice Address - Street 2:
Practice Address - City:TIMNATH
Practice Address - State:CO
Practice Address - Zip Code:80547-4908
Practice Address - Country:US
Practice Address - Phone:970-237-7415
Practice Address - Fax:970-237-7420
Is Sole Proprietor?:No
Enumeration Date:2015-03-27
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD188696207R00000X
CODR.0064095207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine