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General NPI Number Information
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NPI Number | 1417046327
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Entity Type | Individual
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Provider Name | TERRY T JORDAN MD
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Gender | Male
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5000 HWY 39 NORTH
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City | MERIDIAN
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State | MS
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Zip | 39301
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Country | US
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Telephone | 601-482-2400
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Fax | 601-485-2310
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Provider Business Mailing Address
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Address Line | 5000 HIGHWAY 39 N
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City | MERIDIAN
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State | MS
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Zip | 39301-1021
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Country | US
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Telephone | 601-482-2400
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Fax | 601-485-2310
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 14095
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License Number State | MS
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