Individual
DR. SCOTT B. JORDAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1800 12TH ST, MERIDIAN, MS 39301-4158
(601) 703-9222
(601) 703-6770
Mailing address
PO BOX 5183, MERIDIAN, MS 39302-5183
(601) 703-9506
(601) 703-3264
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
13138
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00110619
—
MS
01
—
731-04048
BLUE CROSS OF AL
—
01
—
P00113821
RAILROAD MEDICARE
—
Enumeration date
11/17/2005
Last updated
07/08/2007
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