Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | P18272 | MD |
NPI | 1033261557 |
---|---|
Provider Name | Dr. Joseph Dedrick Jordan |
First Address | Chapel Hill, NC 27517-8326 |
Second Address | Durham, NC 27710-0005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 27/01/2022 |