Individual
DR. JORDAN KENNETH SUSAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 NE 10TH ST # 2102, OKLAHOMA CITY, OK 73104-5495
(405) 271-2230
Mailing address
900 NE 10TH ST # 2102, OKLAHOMA CITY, OK 73104-5420
(405) 271-2230
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41388
OK
Other
Enumeration date
05/19/2023
Last updated
05/19/2023
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