Organization
WILLIAM L. JORDAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM LUKE JORDAN M.D. (OWNER/PRESIDENT)
(248) 547-9292
Entity
Organization
Contact information
Practice address
12900 W 9 MILE RD, OAK PARK, MI 48237-2990
(248) 547-9292
Mailing address
PO BOX 353, SOUTHFIELD, MI 48037-0353
(248) 547-9292
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
048252
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1606306732
BCBSM
—
05
—
4352155 10
—
MI
Enumeration date
09/05/2008
Last updated
01/06/2009
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