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General NPI Number Information
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NPI Number | 1386139350
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Entity Type | Individual
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Provider Name | JORDAN PAUL PEARCE MD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2018
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 240 HOSPITAL PL STE 204B
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City | SOLDOTNA
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State | AK
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Zip | 99669-7559
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Country | US
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Telephone | 907-714-4120
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Fax | 505-272-8098
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Provider Business Mailing Address
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Address Line | 250 HOSPITAL PL
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City | SOLDOTNA
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State | AK
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Zip | 99669-7559
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 216602
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License Number State | AK
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