Individual
DR. ROBERT B JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
622 E REELFOOT AVE, UNION CITY, TN 38261-5739
(731) 885-0541
(731) 885-0588
Mailing address
622 E REELFOOT AVE, UNION CITY, TN 38261-5739
(731) 885-0541
(731) 885-0588
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT1210
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0151506
BLUECROSS BLUESHIELD TN
TN
01
—
0468680001
NATIONAL GOVERNMENT DEMAC
KY
01
—
13835
SPECTRA
TN
05
—
6159
—
TN
01
—
940073
EYEMED
TN
Enumeration date
11/07/2006
Last updated
06/01/2009
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