# DR. JORDAN H TALLEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1205255528
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 0102205112 | VA | Yes |
| 207L00000X | Anesthesiology Physician | 2024031393 | MO | — |
| 207L00000X | Anesthesiology Physician | 87911 | SC | — |

## Other

- **Enumeration date:** 04/15/2014
- **Last updated:** 08/29/2024