Individual
JORDAN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4102 PINION DR, USAF ACADEMY, CO 80840-2502
(719) 524-2273
Mailing address
4102 PINION DR, USAF ACADEMY, CO 80840-2502
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
31213
NE
208D00000X
General Practice Physician
31213
NE
Other
Enumeration date
01/27/2017
Last updated
07/10/2023
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