Jordan, Edmond R

Jordan, Edmond R is an individual health care provider with primary practice located at 895 Tiger Blvd , Clemson SC 29631-1480. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jordan, Edmond R can be contacted via phone (864) 654-6800.

Contact Information

Primary practice address
895 Tiger Blvd Clemson SC 29631-1480
Phone: (864) 654-6800
Fax: (864) 654-7672
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 11861 South Carolina

Profile Details

NPI number 1033173562
LBN Legal business name Jordan, Edmond R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2006
Last updated Jan 18th, 2018 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033173562 NPPES
Other 010056135 RAILROAD MEDICARE
MEDICAID 118615 RAILROAD MEDICARE
Other 6603937 RAILROAD MEDICARE
Other 26142 RAILROAD MEDICARE

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