Individual
JEROME W JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 MIFFLIN AVE, SCRANTON, PA 18503
(570) 342-3145
(570) 344-1309
Mailing address
200 MIFFLIN AVE, SCRANTON, PA 18503
(570) 342-3145
(570) 344-1309
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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