Individual
JORDAN J PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
145 SUNSET CT STE 100, WEST COLUMBIA, SC 29169-2429
(803) 739-3491
Mailing address
145 SUNSET CT STE 100, WEST COLUMBIA, SC 29169-2429
(803) 739-3491
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
90446
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/18/2023
Last updated
03/12/2025
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