Individual
DR. JUSTIN T JORDAN
Active
Individual
DR. JUSTIN T JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
41545
AZ
207L00000X
Anesthesiology Physician
A99764
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
A99764
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
438691
—
AZ
01
—
P00787370
MEDICARE RR
AZ
01
—
P01041174
MEDICARE RR
AZ
Enumeration date
06/02/2008
Last updated
03/07/2023
Update your record
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