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Individual

DAVID W JORDAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 MEDICAL PARK DR, HELENA, MT 59601-8022
(406) 443-3457
(406) 443-7201
Mailing address
1 MEDICAL PARK DR, HELENA, MT 59601-8022
(406) 443-3457
(406) 443-7201

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4325
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000012340
BLUE CROSS BLUE SHIELD
MT
05
055094
MT
01
9989778
MEDICAID PASSPORT
MT
01
P00089863
PALMETTO GBA
Enumeration date
10/21/2005
Last updated
07/21/2009
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