Organization
E L JORDAN JR DO PC
Active
Other names
Jordan Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
EARL LAWRENCE JORDAN JR. DO (PRESIDENT)
(417) 781-0044
Entity
Organization
Contact information
Practice address
2630 CUNNINGHAM AVE, JOPLIN, MO 64804-1542
(417) 781-0044
(417) 781-6331
Mailing address
2630 CUNNINGHAM AVE, JOPLIN, MO 64804-1542
(417) 781-0044
(417) 781-6331
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059024
BLUE CROSS BLUE SHIELD
KS
05
—
100229750B
—
KS
05
—
100229750C
—
KS
05
—
100229750D
—
MO
01
—
106677
BLUE CROSS BLUE SHIELD
MO
05
—
200100060A
—
OK
05
—
505484402
—
MO
01
—
DG3737
RAILROAD MEDICARE
MO
01
—
DG3767
RAILROAD MEDICARE
KS
Enumeration date
10/10/2006
Last updated
01/10/2013
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