Individual
SUSAN ANNE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1526 E. MAIN STREET, MELBOURNE, AR 72556
(870) 368-4344
(870) 368-3051
Mailing address
1526 E. MAIN STREET, MELBOURNE, AR 72556
(870) 368-4344
(870) 368-3051
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E4534
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159002001
—
AR
Enumeration date
03/24/2006
Last updated
05/01/2012
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