Individual
DOUGLAS A JORDAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
11528 US HIGHWAY 19, PORT RICHEY, FL 34668-1442
(727) 868-2151
(727) 868-7379
Mailing address
11528 US HIGHWAY 19, PORT RICHEY, FL 34668-1442
(727) 868-2151
(727) 819-8362
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
PO 2114
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO 2114
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01352
UNIVERSAL HEALTH CARE
FL
05
—
057053200
—
FL
01
—
102751
AVMED
FL
01
—
10593101
CITRUS GCMCI
FL
01
—
10593102
CITRUS GCMCII
FL
01
—
480018908
RAILROAD MEDICARE
FL
01
—
6200309
GHI
FL
01
—
65211
BLUE CROSS BLUE SHIELD FLORIDA
FL
01
—
985373
UNITED HEALTH CARE
FL
Enumeration date
01/09/2006
Last updated
11/30/2009
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