MEDICARE: JORDAN HARRISON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35.151498	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295078442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN HARRISON MD

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0001
Country	:	US
Telephone Number	:	216-444-5600
Fax Number	:

Provider Business Practice Location Address
First Line	:	2050 EAST 96TH STREET
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-4479
Country	:	US
Telephone Number	:	303-372-4010
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2013
Last Update Date	:	07/16/2024

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Directions to “ JORDAN HARRISON MD” Practice Location

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