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General NPI Number Information
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NPI Number | 1568685485
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Entity Type | Individual
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Provider Name | CHRISTINE D JORDAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 3698 S MAIN ST
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City | BLACKSBURG
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State | VA
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Zip | 24060-7015
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Country | US
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Telephone | 540-951-6070
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Fax | 540-951-6071
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Provider Business Mailing Address
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Address Line | 4130 CRIMSON DR
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City | BLACKSBURG
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State | VA
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Zip | 24060-8690
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Country | US
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Telephone | 540-808-2486
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101240806
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License Number State | VA
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