Individual
LESA JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
710 N MAIN ST, MEMPHIS, TN 38107-2310
(901) 626-2266
Mailing address
710 N MAIN ST, MEMPHIS, TN 38107-2310
(901) 626-2266
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
18383
MS
207P00000X
Emergency Medicine Physician
35942
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04939709
—
MS
05
—
3880023
—
TN
01
—
P00427604
RAILROAD MCR
—
Enumeration date
05/28/2006
Last updated
08/05/2014
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