Provider Demographics
NPI:1548693567
Name:CASSIDY, JORDAN (DVM)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:
Last Name:CASSIDY
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BVMTH
Mailing Address - Street 2:OKLAHOMA STATE UNIVERSITY
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74078-0001
Mailing Address - Country:US
Mailing Address - Phone:405-744-6656
Mailing Address - Fax:
Practice Address - Street 1:1 BVMTH
Practice Address - Street 2:OKLAHOMA STATE UNIVERSITY
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74078-0001
Practice Address - Country:US
Practice Address - Phone:405-744-6656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5611174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian