Individual
JOHN N JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3816 HIGHWAY 17 S, NORTH MYRTLE BEACH, SC 29582-5069
(843) 272-1411
(843) 272-2130
Mailing address
4728 JENN DR STE 104, MYRTLE BEACH, SC 29577-5714
(843) 449-2272
(843) 236-5088
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13156
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DB4083
RAILROAD MEDICARE
SC
Enumeration date
10/06/2005
Last updated
05/09/2019
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