Individual
MR. CECIL BRYAN JORDAN II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
109 DUKES ST, ST GEORGE, SC 29477
(843) 563-2484
(843) 563-7222
Mailing address
109 DUKES ST, ST GEORGE, SC 29477
(843) 563-2484
(843) 563-7222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11810
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118107
—
SC
Enumeration date
06/09/2006
Last updated
01/08/2010
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