Individual
JACOB RODDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
175 INVERNESS DR W STE 200, ENGLEWOOD, CO 80112-5069
(720) 848-0000
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
PA.0007444
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2021
Last updated
10/14/2022
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