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Individual
JORDAN RUTHERFORD
Active
Individual
JORDAN RUTHERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
42434
AL
208000000X
Pediatrics Physician
ME143517
FL
208000000X
Pediatrics Physician
T-3420
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518498054
BLUE CROSS AND BLUE SHIELD
AL
05
—
265009
—
AL
Enumeration date
03/26/2017
Last updated
02/22/2022
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