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General NPI Number Information
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NPI Number | 1730595521
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Entity Type | Individual
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Provider Name | JORDAN MAX PAUL O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/01/2014
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 5650 S CHAMBERS RD
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City | AURORA
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State | CO
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Zip | 80015-1132
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Country | US
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Telephone | 303-690-1521
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Fax | 303-690-6736
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Provider Business Mailing Address
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Address Line | 14307 DOUBLE DUTCH CIR
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City | PARKER
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State | CO
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Zip | 80134-8909
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Country | US
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Telephone | 720-419-9923
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Fax | 303-690-6736
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0003064
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License Number State | CO
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