Individual
DR. JAMES L. JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
331 HOSPITAL DR, SUITE D, LEBANON, MO 65536-9217
(417) 532-3495
(417) 532-3598
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
2000160358
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205006406
—
MO
Enumeration date
10/17/2006
Last updated
10/05/2015
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