Provider Demographics
NPI:1861470247
Name:SHIP, JORDAN R (MD)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:R
Last Name:SHIP
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2550 S PARKER RD
Mailing Address - Street 2:STE 206
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1622
Mailing Address - Country:US
Mailing Address - Phone:303-306-7783
Mailing Address - Fax:303-306-7753
Practice Address - Street 1:55 FOGG RD
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190
Practice Address - Country:US
Practice Address - Phone:781-624-8000
Practice Address - Fax:303-306-7753
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO35127207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01351279Medicaid
COF51383Medicare UPIN
COE50046Medicare ID - Type Unspecified