DR. Jordan Tyler Shively, D.O.

NPI #1194170910 in Las Vegas, Nevada

Provider Information

NPI Number: 1194170910
Entity Type: Individual
Name: DR. Jordan Tyler Shively, D.O.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Surgery
Credential: D.O.
Enumeration Date: Apr 29, 2016
Last Updated: Jul 1, 2021

Practice Location

Address: 8930 W SUNSET RD STE 300
City: Las Vegas
State: Nevada
ZIP Code: 89148-5013
Phone: (702) 228-8834

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Surgery	208600000X	Primary

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