Provider Demographics
NPI:1730595521
Name:PAUL, JORDAN MAX (OD)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:MAX
Last Name:PAUL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14307 DOUBLE DUTCH CIR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-8909
Mailing Address - Country:US
Mailing Address - Phone:720-419-9923
Mailing Address - Fax:303-690-6736
Practice Address - Street 1:5650 S CHAMBERS RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1132
Practice Address - Country:US
Practice Address - Phone:303-690-1521
Practice Address - Fax:303-690-6736
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003064152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist