Individual
JORDAN RUTHERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
421 W COLLEGE ST, FLORENCE, AL 35630-5520
(256) 764-9522
(256) 764-1139
Mailing address
241 W COLLEGE STREET, FLORENCE, AL 35630
(256) 764-9522
(256) 764-1139
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
42434
AL
208000000X
Pediatrics Physician
ME143517
FL
208000000X
Pediatrics Physician
T-3420
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518498054
BLUE CROSS AND BLUE SHIELD
AL
05
—
265009
—
AL
Enumeration date
03/26/2017
Last updated
02/22/2022
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