Individual
DR. MARK K JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
711 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017
(859) 287-3045
(859) 578-3800
Mailing address
PO BOX 636324, CINCINNATI, OH 45263-6324
(859) 287-3045
(859) 578-3800
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01071044A
IN
207RC0000X
Cardiovascular Disease Physician
38774
KY
207RI0011X
Interventional Cardiology Physician
01071044A
IN
207RI0011X
Interventional Cardiology Physician
Primary
38774
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200501330
—
IN
05
—
2528572
—
OH
05
—
50024715
—
KY
05
—
64083108
—
KY
01
—
P00920128
RAILROAD MEDICARE
KY
Enumeration date
05/23/2005
Last updated
12/18/2025
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