MEDICARE: ERIKA ANTIONETTE JORDAN

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	207PP0204X	Pediatric Emergency Medicine (Emergency Medicine) Physician	212649	AR

General Provider Information

NPI Number	:	1518896067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIKA ANTIONETTE JORDAN

Provider Business Mailing Address
First Line	:	4301 W MARKHAM ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-7199
Country	:	US
Telephone Number	:	501-686-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 CHILDRENS WAY
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72202-3500
Country	:	US
Telephone Number	:	501-364-1100
Fax Number	:

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

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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Directions to “ ERIKA ANTIONETTE JORDAN ” Practice Location

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