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General NPI Number Information
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NPI Number | 1578744215
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Entity Type | Organization
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Legal Business Name | EDWARD F JORDAN MD PC
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Dates
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Enumeration Date | 11/23/2007
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Last Update Date | 02/08/2013
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Provider Practice Location Address
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Address Line | 516 MAIN ST
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City | OLEAN
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State | NY
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Zip | 14760-1514
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Country | US
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Telephone | 716-372-7600
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Fax | 716-372-9680
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Provider Business Mailing Address
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Address Line | 516 MAIN ST
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City | OLEAN
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State | NY
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Zip | 14760-1514
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Country | US
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Telephone | 716-372-7600
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Fax | 716-372-9680
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. EDWARD F JORDAN
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Credential | MD
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Telephone | 716-372-7600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 125792
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125792
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License Number State | NY
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