Dr. Christian William Jordan, O.D.
Optometrist in Columbia, SC. Individual provider (NPI-1).
NPI number1417153644
StatusActive
Last updated in NPPESApr 24, 2009
Details
- NPI
- 1417153644
- Entity type
- Individual (NPI-1)
- Name
- Dr. Christian William Jordan
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 25, 2007
- Last updated
- Apr 24, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | SC-1428 | SC | Yes |
Practice location
6439 Garners Ferry RdColumbia, SC 29209-1638
Phone 803-776-4000
Mailing address
1140 Rockwood RdColumbia, SC 29209-1638
Phone 856-534-0586
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