Individual
DR. KERRY BRUCE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11301 ASH ST, LEAWOOD, KS 66211-1643
(913) 338-4515
(913) 338-4606
Mailing address
PO BOX 412554, KANSAS CITY, MO 64141-2554
(913) 338-4515
(913) 338-4606
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-24272
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCBS OF KANSAS CITY
PROVIDER NUMBER
MO
Enumeration date
09/25/2006
Last updated
05/25/2017
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