Provider Demographics
NPI:1649261520
Name:JORDAN, JAMIE RYAN (MD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:RYAN
Last Name:JORDAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 SOUTHPARK DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-5654
Mailing Address - Country:US
Mailing Address - Phone:303-744-1065
Mailing Address - Fax:303-733-1699
Practice Address - Street 1:1000 SOUTHPARK DR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-5654
Practice Address - Country:US
Practice Address - Phone:303-744-1065
Practice Address - Fax:303-733-1699
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA224348207R00000X
CO53424207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine