Individual
JORDAN KENNETH MARSHALL
Active
Individual
JORDAN KENNETH MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036160684
IL
2083A0100X
Aerospace Medicine Physician
0101257159
VA
208D00000X
General Practice Physician
0101257159
VA
Other
Enumeration date
04/11/2013
Last updated
12/18/2023
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