Individual
DR. JORDAN TYLER SHIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8930 W SUNSET RD STE 300, LAS VEGAS, NV 89148-5013
(702) 228-8834
Mailing address
8930 W SUNSET RD STE 300, LAS VEGAS, NV 89148-5013
(702) 228-8834
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
DO2821
NV
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Enumeration date
04/29/2016
Last updated
07/01/2021
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