Individual
DR. ROGER WAYNE JORDAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
(000) 000-0000
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
66463
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP10052905
TEXAS MEDICAL BOARD PHYCIAN-IN-TRAINING PERMIT
TX
Enumeration date
05/29/2015
Last updated
10/25/2021
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