MEDICARE: MIGUEL ANGEL JORDAN 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	207V00000X	Obstetrics & Gynecology Physician	35-05-5785-J	OH
2	207V00000X	Obstetrics & Gynecology Physician	36853	IA
3	207V00000X	Obstetrics & Gynecology Physician	TL783	WY

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	:	1750417788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIGUEL ANGEL JORDAN MD

Provider Business Mailing Address
First Line	:	1900 CHAPEL DR
Second Line	:
City	:	FINDLAY
State	:	OH
Zip	:	45840-1296
Country	:	US
Telephone Number	:	419-425-3211
Fax Number	:	419-425-4440

Provider Business Practice Location Address
First Line	:	1900 CHAPEL DR
Second Line	:
City	:	FINDLAY
State	:	OH
Zip	:	45840-1296
Country	:	US
Telephone Number	:	419-425-3211
Fax Number	:	419-425-4440

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	08/13/2008

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