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Individual

BARBARA JORDAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
36000 EUCLID AVE, WILLOUGHBY, OH 44094
(440) 953-6203
(440) 953-6202
Mailing address
9291 HIDDEN GLEN DR, MENTOR, OH 44060
(440) 974-0557

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34002925J
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0433570
OH
Enumeration date
03/30/2006
Last updated
09/15/2011
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