Individual
ROBERT BRUCE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
253 WILDERNESS DR, BOYCE, LA 71409-8618
(318) 443-2418
(318) 443-2410
Mailing address
PO BOX 7146, ALEXANDRIA, LA 71306-0146
(805) 901-0204
(318) 443-2410
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
C26156
CA
2085R0202X
Diagnostic Radiology Physician
J1277
TX
2085R0202X
Diagnostic Radiology Physician
Primary
MD.009180
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C261560
—
CA
05
—
GR0106037
—
CA
Enumeration date
06/08/2006
Last updated
07/07/2009
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