Individual
DR. JORDAN MYHRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2521 GLENN HENDREN DR STE 108, LIBERTY, MO 64068-3388
(167) 813-5158
Mailing address
2521 GLENN HENDREN DR, LIBERTY, MO 64068-3388
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2021028178
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021028178
LICENSE
MO
Enumeration date
04/08/2016
Last updated
07/26/2021
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