Basic Information
| Provider Information | |||||||||
| NPI: | 1679732929 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHAEFFER | ||||||||
| FirstName: | JORDAN | ||||||||
| MiddleName: | FORISTER | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8890 N UNION BLVD STE 171 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809202701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7193645633 | ||||||||
| FaxNumber: | 7193645639 | ||||||||
| Practice Location | |||||||||
| Address1: | 5818 N NEVADA AVENUE | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809182701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7193651950 | ||||||||
| FaxNumber: | 7193645639 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2008 | ||||||||
| LastUpdateDate: | 12/08/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0114X | 8633099-1205 | UT | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Adult Reconstructive Orthopaedic Surgery | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207X00000X | DR0059076 | CO | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.