Individual
DR. DAVID LEE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2601 JEWELLA, SHREVEPORT, LA 71109
(318) 631-5511
Mailing address
2601 JEWELLA, SHREVEPORT, LA 71109
(318) 631-5511
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8931017
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1314561
—
LA
Enumeration date
04/12/2006
Last updated
11/22/2013
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