Healthcare Provider Details

I. General information

NPI: 1679523625
Provider Name (Legal Business Name): CHRISTOPHER GRIFFITH JORDAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 S 5TH ST
MONTROSE CO
81401-5765
US

IV. Provider business mailing address

5450 CLEARFORK MAIN ST STE 200
FORT WORTH TX
76109-3562
US

V. Phone/Fax

Practice location:
  • Phone: 970-497-8001
  • Fax: 970-240-7793
Mailing address:
  • Phone: 682-707-4545
  • Fax: 817-804-8160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberL1085
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberL1085
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberDR.0069658
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberDO-986
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: