Individual
MR. THOMAS M JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1285 UPPER HEMBREE RD, ROSWELL, GA 30076-1143
(770) 343-8565
(770) 343-8651
Mailing address
1285 UPPER HEMBREE RD, ROSWELL, GA 30076-1143
(770) 343-8565
(770) 343-8651
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
30329
GA
207RI0011X
Interventional Cardiology Physician
030329
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00395568B
—
GA
01
—
060029873
MEDICARE RAILROAD
GA
Enumeration date
09/16/2006
Last updated
02/26/2021
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