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General NPI Number Information
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NPI Number | 1801606793
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Entity Type | Individual
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Provider Name | JORDAN SAXERUD
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Gender | Male
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 12600 W COLFAX AVE STE B200
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City | LAKEWOOD
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State | CO
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Zip | 80215-3736
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Country | US
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Telephone | 303-993-1330
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Fax |
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Provider Business Mailing Address
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Address Line | 10327 BURGUNDY DR
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City | HORACE
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State | ND
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Zip | 58047-9020
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Country | US
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Telephone | 701-308-0386
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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