Individual
JORDAN M BURNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
303 VETERANS BLVD STE A, DENHAM SPRINGS, LA 70726-4723
(225) 523-7624
(225) 523-7625
Mailing address
303 VETERANS BLVD STE A, DENHAM SPRINGS, LA 70726-4723
(225) 523-7624
(225) 523-7625
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
307857
LA
207WX0107X
Retina Specialist (Ophthalmology) Physician
307857
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
307857
LA MEDICAL LICENSE
LA
Enumeration date
06/29/2012
Last updated
05/18/2022
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