Jordan, Kenneth Wayne
Jordan, Kenneth Wayne is an individual health care provider with primary practice located at 2100 Erwin Rd , Durham NC 27705-3941. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Jordan, Kenneth Wayne can be contacted via phone (919) 684-8111.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 33260 | North Carolina |
Profile Details
| NPI number | 1184628505 |
|---|---|
| LBN Legal business name | Jordan, Kenneth Wayne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2005 |
| Last updated | Sep 1st, 2009 - about 17 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 | 1184628505 | NPPES |
| North Carolina | MEDICAID | BJ1675531 | |
| North Carolina | MEDICAID | 8947445 |
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