Randall W Jordan
Optometrist
1107 E South Greer Street
Cordele
, Georgia 31015
Randall W Jordan
Optometrist
1107 E South Greer Street
Cordele
, Georgia 31015
(229) 273-0102
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Randall W Jordan
- Po Box 5103
- Cordele, GA
- Zip : 31010-5103
- Fax : (229) 273-0102
- Phone : (229) 273-0018
Second Address
- Randall W Jordan
- 1107 E South Greer Street
- Cordele, GA
- Zip : 31015
- Fax : (229) 273-0102
- Phone : (229) 273-0018
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1192 | GA |
National Provider Identifier
| NPI | 1003917956 |
|---|---|
| Provider Name | Randall W Jordan |
| First Address | Cordele, GA 31010-5103 |
| Second Address | Cordele, GA 31015 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/09/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00414455F | (05) | GA |
| U22421 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.