MEDICARE: DR. JORDAN I FRISHMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	DR.0036317	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01578825	OTHER	CO	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467453837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORDAN I FRISHMAN M.D.

Provider Business Mailing Address
First Line	:	1625 FOXTRAIL DR
Second Line	:	STE 200
City	:	LOVELAND
State	:	CO
Zip	:	80538-9089
Country	:	US
Telephone Number	:	970-224-0429
Fax Number	:

Provider Business Practice Location Address
First Line	:	1625 FOXTRAIL DR
Second Line	:	SUITE 200
City	:	LOVELAND
State	:	CO
Zip	:	80538-9088
Country	:	US
Telephone Number	:	970-490-4209
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	08/05/2021

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