Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 35.090009 | OH |
N | 207RC0000X | Internist - Cardiovascular Disease | 15205 | TN |
N | 207RC0000X | Internist - Cardiovascular Disease | 35090009 | OH |
NPI | 1114917598 |
---|---|
Provider Name | Lee Jordan |
First Address | Dublin, OH 43016-6102 |
Second Address | Columbus, OH 43214-3937 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2005 |
Last Update Date | 10/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2763611 | (05) | OH |
E43136 | (02) | TN |