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Individual

MR. MICHAEL T JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
927 FRANKLIN ST SE, THE ORTHOPAEDIC CENTER, HUNTSVILLE, AL 35801-4306
(256) 539-2728
(256) 428-3423
Mailing address
927 FRANKLIN ST SE, THE ORTHOPAEDIC CENTER, HUNTSVILLE, AL 35801-4306
(256) 539-2728
(256) 428-3423

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA513
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009913302
AL
01
51546369
BCBS
AL
01
7088895
AETNA
AL
01
POO777891
RAILROAD MEDICARE
AL
Enumeration date
11/03/2006
Last updated
02/08/2010
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