Individual
JAMES RANDALL JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, DEPARTMENT OF OTOLARYNGOLOGY, JACKSON, MS 39216-4500
(601) 984-5160
(601) 815-6985
Mailing address
2500 N STATE ST, DEPARTMENT OF OTOLARYNGOLOGY, JACKSON, MS 39216-4500
(601) 984-5160
(601) 815-6985
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
17643
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0125977
—
MS
01
—
P00660862
MEDICARE RAILROAD
—
Enumeration date
01/30/2006
Last updated
01/31/2013
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