Individual
BENJAMIN C JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
69722-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922393396
—
WI
Enumeration date
06/14/2011
Last updated
04/09/2026
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