Individual
DR. JONATHAN GRANT LORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1801 16TH ST, GREELEY, CO 80631-5154
(970) 352-4121
(970) 515-6576
Mailing address
1707 36TH AVENUE CT, GREELEY, CO 80634-2807
(970) 330-1121
(970) 515-6576
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
19999
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01199991
—
CO
Enumeration date
05/08/2006
Last updated
06/10/2011
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