Individual
JOHN S JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1850 N CENTRAL AVE, SUITE 1600, PHOENIX, AZ 85004-4527
(602) 262-8900
(602) 262-8890
Mailing address
645 E MISSOURI AVE, STE 300, PHOENIX, AZ 85012-1351
(602) 262-8900
(602) 262-8890
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
43811
AZ
207L00000X
Anesthesiology Physician
MD18110
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050027241
RAILROAD MEDICARE
OR
05
—
116173
—
OR
05
—
584917
—
AZ
01
—
A020
TRICARE
OR
Enumeration date
07/04/2006
Last updated
11/09/2020
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