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Individual

JESSE JAMES RAY JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2718 HENRY ST, GREENSBORO, NC 27405-3633
(336) 375-1007
(336) 375-9615
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 375-1007
(336) 375-9615

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-12632
NC
363AM0700X
Medical Physician Assistant
363AS0400X
Surgical Physician Assistant
0010-12632
NC

Other

Enumeration date
09/13/2022
Last updated
01/09/2026
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