Healthcare Provider Details

I. General information

NPI: 1053809202
Provider Name (Legal Business Name): JORDAN ROSS KUMP MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2018
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 HALE PKWY STE 550
DENVER CO
80220-4053
US

IV. Provider business mailing address

8101 E LOWRY BLVD STE 120
DENVER CO
80230-7195
US

V. Phone/Fax

Practice location:
  • Phone: 303-321-6600
  • Fax:
Mailing address:
  • Phone: 303-321-6600
  • Fax: 303-321-8814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberDR.0073320
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: