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Individual

EDWARD JORDAN STOLL JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3455 LUTHERAN PKWY STE 105, WHEAT RIDGE, CO 80033-6028
(303) 665-2603
(303) 665-2605
Mailing address
3455 LUTHERAN PKWY, STE 105, WHEAT RIDGE, CO 80033-6028
(303) 665-2603
(303) 665-2605

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
30560
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01305606
CO
Enumeration date
08/11/2006
Last updated
03/17/2018
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