Organization
TIMOTHY D. JORDAN, MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY D JORDAN MD (MEMBER)
(919) 782-5400
Entity
Organization
Contact information
Practice address
2709 BLUE RIDGE RD, SUITE 100, RALEIGH, NC 27607-6462
(919) 782-5400
(919) 782-1680
Mailing address
2709 BLUE RIDGE RD, SUITE 100, RALEIGH, NC 27607-6462
(919) 782-5400
(919) 782-1680
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
9800583
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1038G
BCBS
NC
05
—
891038G
—
NC
Enumeration date
11/10/2006
Last updated
08/22/2020
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