Individual
DR. MARK VERNON JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
240 HOSPITAL DR NE, BOLIVIA, NC 28422-8346
(910) 721-2070
(910) 721-2074
Mailing address
300 W 27TH ST, LUMBERTON, NC 28358-3075
(910) 671-5000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2007-01129
NC
208M00000X
Hospitalist Physician
Primary
2007-01129
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14620
BCBS
NC
05
—
5907603
—
NC
Enumeration date
11/01/2006
Last updated
11/05/2025
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