Individual
DR. ELIZABETH DIAL JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
414 N CRAFT HWY, CHICKASAW, AL 36611-1312
(251) 452-0531
(251) 456-1529
Mailing address
414 N CRAFT HWY, CHICKASAW, AL 36611-1312
(251) 452-0531
(251) 456-1529
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14372
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14372
REGISTERED PHARMACIST
AL
01
—
PS39299
REGISTERED PHARMACIST- INACTIVE STATUS
FL
Enumeration date
06/19/2016
Last updated
06/19/2016
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