Individual
BENJAMIN EDWARD JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
210 25TH AVE N, SUITE 602, NASHVILLE, TN 37203
(615) 312-0600
(615) 320-3259
Mailing address
601 DODDS AVE, CHATTANOOGA, TN 37404-3911
(866) 730-5619
(423) 698-3622
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
34238
AL
2085R0202X
Diagnostic Radiology Physician
Primary
51300
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04357014
—
MS
05
—
172629
—
AL
01
—
511-61752
BLUE CROSS BLUE SHIELD
AL
05
—
Q006343
—
TN
Enumeration date
05/15/2009
Last updated
10/10/2018
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