Individual
WILLIAM D JORDAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-1013
(706) 721-8623
Mailing address
1120 15TH ST # OR6000, AUGUSTA, GA 30912-0004
(706) 721-3813
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
14678
AL
2086S0129X
Vascular Surgery Physician
Primary
37578
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000027366
BLUE CROSS
AL
05
—
000027366
—
AL
01
—
770000637
RAILROAD MEDICARE
AL
01
—
E92967
VIVA
AL
Enumeration date
07/03/2006
Last updated
07/12/2023
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