Jordan, Jody Lea
Jordan, Jody Lea is an sole proprietor health care provider with primary practice located at 1001 Coal Ave Se , Albuquerque NM 87106-5205. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Jordan, Jody Lea can be contacted via phone (505) 938-5858.Contact Information
Primary practice address
1001 Coal Ave Se
Albuquerque NM 87106-5205
Phone: (505) 938-5858
Fax: (505) 938-5861
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 2006-0632 | New Mexico |
Profile Details
| NPI number | 1518014794 |
|---|---|
| LBN Legal business name | Jordan, Jody Lea |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 3rd, 2007 |
| Last updated | Jul 16th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518014794 | NPPES |
| New Mexico | MEDICAID | 54654823 |
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