Healthcare Provider Details

I. General information

NPI: 1467453837
Provider Name (Legal Business Name): JORDAN I FRISHMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 FOXTRAIL DR SUITE 200
LOVELAND CO
80538-9088
US

IV. Provider business mailing address

1625 FOXTRAIL DR STE 200
LOVELAND CO
80538-9089
US

V. Phone/Fax

Practice location:
  • Phone: 970-490-4209
  • Fax:
Mailing address:
  • Phone: 970-224-0429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberDR.0036317
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: