Organization
WILLIAM R. JORDAN, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM RICHIE JORDAN M.D. (PHYSICIAN-OWNER)
(334) 297-7790
Entity
Organization
Contact information
Practice address
1212 7TH AVE STE B, PHENIX CITY, AL 36867-5805
(334) 297-7790
(334) 297-7127
Mailing address
1212 7TH AVE STE B, PHENIX CITY, AL 36867-5805
(334) 297-7790
(334) 297-7127
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207VG0400X
Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790768646
—
AL
Enumeration date
08/29/2012
Last updated
08/29/2012
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