Individual
JEFFREY DERRICK MANORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD23436
AL
2086S0129X
Vascular Surgery Physician
Primary
23436
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126779
—
AL
01
—
511-17526
BCBS OF ALABAMA
AL
Enumeration date
05/20/2006
Last updated
03/29/2022
Update your record
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