Individual
JORDAN O BOOTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, 1 SILVERSTEIN, PHILADELPHIA, PA 19104
(215) 662-3000
Mailing address
3400 SPRUCE ST, 1 SILVERSTEIN, PHILADELPHIA, PA 19104
(215) 662-3000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD451981
PA
Other
Enumeration date
12/09/2008
Last updated
05/30/2014
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