Individual
DR. JORDAN B INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
950 MATTHEW DR, WAYNESBORO, MS 39367-2590
(601) 735-5151
(601) 735-7169
Mailing address
950 MATTHEW DR, WAYNESBORO, MS 39367-2590
(601) 735-5151
(601) 735-7169
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2023041851
MO
207P00000X
Emergency Medicine Physician
Primary
25095
MS
207P00000X
Emergency Medicine Physician
57323
TN
207Q00000X
Family Medicine Physician
25095
MS
Other
Enumeration date
05/26/2015
Last updated
09/25/2024
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