Provider Demographics
NPI:1679732929
Name:SCHAEFFER, JORDAN FORISTER (MD)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:FORISTER
Last Name:SCHAEFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8890 N UNION BLVD STE 171
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-2701
Mailing Address - Country:US
Mailing Address - Phone:719-364-5633
Mailing Address - Fax:719-364-5639
Practice Address - Street 1:5818 N NEVADA AVENUE
Practice Address - Street 2:SUITE 110
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-2701
Practice Address - Country:US
Practice Address - Phone:719-365-1950
Practice Address - Fax:719-364-5639
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8633099-1205207XS0114X
390200000X
CODR0059076207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program