Individual
LYNDON KIRKMAN JORDAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3949 BROWNING PL, RALEIGH, NC 27609-6504
(919) 787-8221
(919) 881-2079
Mailing address
PO BOX 19368, RALEIGH, NC 27619-9368
(919) 787-8221
(919) 881-2079
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
95-00961
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10042
BLUECROSS BLUESHIELD
NC
01
—
16-55210
UNITED HEALTHCARE
NC
01
—
16-55297
UNITED HEALTHCARE
NC
01
—
16-55299
UNITED HEALTHCARE
NC
01
—
300105902
RAILROAD MEDICARE
NC
01
—
300105903
RAILROAD MEDICARE
NC
01
—
300105905
RAILROAD MEDICARE
NC
01
—
88076
MEDCOST
NC
05
—
8910042
—
NC
01
—
92583
MEDCOST
NC
01
—
92585
MEDCOST
NC
Enumeration date
06/06/2006
Last updated
02/15/2018
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