Individual
J DOUGLAS JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 MADISON ST, SYRACUSE, NY 13210-2319
(315) 426-3600
Mailing address
620 MADISON ST, SYRACUSE, NY 13210-2319
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
231140
NY
Other
Enumeration date
02/08/2007
Last updated
07/08/2007
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