Individual
DR. JOSEPH J JORDAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
8 LILAC MALL, ROCHESTER, NH 03867-1350
(603) 335-6666
Mailing address
8 LILAC MALL, ROCHESTER, NH 03867-1350
(603) 335-6666
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0495
NH
152W00000X
Optometrist
3093
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020493870
TAX ID
—
01
—
0907469Y0NH01
BCBS PROVIDER NUMBER
NH
05
—
40009434
—
NH
01
—
7515834
CIGNA PROVIDER
—
01
—
NA1153
HARVARD PILGRIM PROVIDER
—
Enumeration date
02/15/2006
Last updated
01/13/2010
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