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NPI 1538800073

NPI 1538800073 : JORDAN FINN DO : POCATELLO, ID

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General NPI Number Information
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    NPI Number           |    1538800073
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    Entity Type          |    Individual 
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    Provider Name        |    JORDAN FINN DO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/06/2022
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    Last Update Date     |    08/13/2025
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Provider Practice Location Address
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    Address Line         |    777 HOSPITAL WAY 
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    City                 |    POCATELLO
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    State                |    ID
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    Zip                  |    83201-5175
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    Country              |    US
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    Telephone            |    208-239-1000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1601 CUMMINS DR STE D 
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    City                 |    MODESTO
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    State                |    CA
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    Zip                  |    95358-6411
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    9371961
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    License Number State |    ID
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Taxonomy #3
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    Taxonomy Code        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    8099
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    License Number State |    OK
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