Individual
DR. THOMAS EDISON JORDAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., M.P.H.
Contact information
Practice address
197 RIDGE RD, JUPITER, FL 33477-9660
(561) 339-7205
(561) 746-7297
Mailing address
197 RIDGE RD, JUPITER, FL 33477-9660
(561) 339-7205
(561) 746-7297
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
4301060662
MI
2084P0800X
Psychiatry Physician
52715
MA
2084P0800X
Psychiatry Physician
Primary
ME59988
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266699500
—
FL
Enumeration date
05/31/2005
Last updated
01/16/2011
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