Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 541 | SC |
NPI | 1285623827 |
---|---|
Provider Name | Dr. Sarah M Jordan |
First Address | Spartanburg, SC 29306-3911 |
Second Address | Spartanburg, SC 29306-3911 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2005 |
Last Update Date | 08/07/2007 |