NPI 1356506455

Robert W. Jordan MD PC

Organisation Specialist Bountiful, UT

Practice location

Address: 1551 Renaissance Towne Dr Suite 400, Bountiful, UT 84010-7667
Phone: (801) 295-7200
Fax: (801) 295-4930

Authorised official

Name: Robert W Jordan
Title: Corporate President
Phone: (801) 295-7200

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 166068-1205 (UT)

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Registry record

NPI: 1356506455
Entity type: Organization
NPI issued: 28 Jul 2008
Record last updated: 30 Apr 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.