Individual
GERALD H JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 CLEARFIELD AVE, VIRGINIA BEACH, VA 23462-1815
(757) 457-5110
(757) 466-3411
Mailing address
225 CLEARFIELD AVE, VIRGINIA BEACH, VA 23462-1815
(757) 457-5110
(757) 466-3411
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101037957
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007501587
—
VA
01
—
15921
SENTARA HEALTHCARE
VA
01
—
340012060
RR MEDICARE
—
Enumeration date
01/18/2006
Last updated
07/26/2012
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