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NPI Code Detail

MEDICARE: DR. JOHN MICHAEL JORDAN M.D.

MEDICARE:  DR. JOHN MICHAEL JORDAN  M.D.
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
1207RP1001XPulmonary Disease PhysicianG3504TX

General Provider Information

NPI Number : 1295736437
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN MICHAEL JORDAN M.D.
Provider Business Mailing Address
First Line : 3600 GASTON AVE
Second Line : LB-143
City : DALLAS
State : TX
Zip : 75246-1800
Country : US
Telephone Number : 214-827-0067
Fax Number : 214-827-8840
Provider Business Practice Location Address
First Line : 3600 GASTON AVE
Second Line : SUITE 806
City : DALLAS
State : TX
Zip : 75246-1800
Country : US
Telephone Number : 214-824-8521
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 07/08/2007

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Directions to “ DR. JOHN MICHAEL JORDAN M.D.” Practice Location

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