Provider Demographics
NPI:1467453837
Name:FRISHMAN, JORDAN I (MD)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:I
Last Name:FRISHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 FOXTRAIL DR
Mailing Address - Street 2:STE 200
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9089
Mailing Address - Country:US
Mailing Address - Phone:970-224-0429
Mailing Address - Fax:
Practice Address - Street 1:1625 FOXTRAIL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9088
Practice Address - Country:US
Practice Address - Phone:970-490-4209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0036317207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY141180200Medicaid
COP01578825OtherRR MEDICARE
NE10025181600Medicaid
CO60826576Medicaid
NE10025181600Medicaid