Individual
TODD JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 536-2146
(770) 536-7895
Mailing address
PO BOX 2938, GAINESVILLE, GA 30503-2938
(770) 536-2146
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
035915
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000517844J
—
GA
05
—
000517844K
—
GA
01
—
000517844L
MEDICAID URGENT CARE FRIENDSHIP
GA
01
—
511I930016
MEDICARE PIN URGENT CARE FRIENDSHIP
GA
Enumeration date
02/28/2006
Last updated
06/04/2008
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