Individual
MRS. MEREDITH JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1204 W MAIN ST, CHARLOTTESVILLE, VA 22903-2824
(434) 243-5500
Mailing address
PO BOX 735, MADISON, MS 39130-0735
(601) 316-4054
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101276695
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2019
Last updated
03/06/2023
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