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Individual

DR. JORDAN DOUGLASS BIRCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1102 W 32ND ST, JOPLIN, MO 64804-3503
(417) 347-4616
Mailing address
8500 MARYLAND AVE APT 708, SAINT LOUIS, MO 63124-2314
(317) 755-8951

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2018010268
MO
390200000X
Student in an Organized Health Care Education/Training Program
MO

Other

Enumeration date
06/21/2016
Last updated
06/09/2020
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