Individual
DR. THEODORE FOSTER JORDAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 KEYSER AVE, NATCHITOCHES, LA 71457-6020
(318) 214-5770
Mailing address
PO BOX 2475, NATCHITOCHES, LA 71457-2475
(318) 663-6131
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD.323324
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00125687
—
MS
Enumeration date
07/18/2005
Last updated
07/15/2020
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