Individual
DR. ROBERT B JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
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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