Individual
JEROME W JORDAN
Active
Individual
JEROME W JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD013648E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000736271
—
PA
01
—
072545
FIRST PRIORITY HEALTH
—
01
—
11512
GEISINGER HEALTH PLAN
—
01
—
180010570
RAILROAD MEDICARE
—
01
—
506554
AETNA
—
01
—
JO143571
HIGH MARK BLUE SHIELD
—
Enumeration date
08/31/2006
Last updated
12/01/2022
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