Individual
MANLEY MCRAE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2770 3RD AVE, SUITE 110, LAKE CHARLES, LA 70601-8994
(337) 494-2750
(337) 494-2760
Mailing address
PO BOX 122309, DEPT 2309, DALLAS, TX 75312-2309
(337) 494-2919
(337) 494-3069
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
017837
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1468444
—
LA
01
—
P00221352
RAILROAD MEDICARE
LA
Enumeration date
08/05/2006
Last updated
12/02/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us