Provider Demographics
NPI:1912313875
Name:HIRSCHI, JORDAN FRANK (DPM)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:FRANK
Last Name:HIRSCHI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2147 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-3179
Mailing Address - Country:US
Mailing Address - Phone:801-831-3164
Mailing Address - Fax:
Practice Address - Street 1:2147 N 30TH ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85213-3179
Practice Address - Country:US
Practice Address - Phone:801-831-3164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-10
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0848213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery