Individual
DR. TARA LEIGH JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3303A GLYNN AVE, BRUNSWICK, GA 31520-4406
(912) 466-9500
(912) 466-9922
Mailing address
3303A GLYNN AVE, BRUNSWICK, GA 31520-4406
(912) 466-9500
(912) 466-9922
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002683
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPT002683
GA LICENSE
GA
Enumeration date
06/29/2011
Last updated
08/04/2025
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