Provider Demographics
NPI:1730278219
Name:JORDAN, HARRY JAMES (MD)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:JAMES
Last Name:JORDAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1008 16TH AVENUE
Mailing Address - Street 2:SUITE 100 H JAMES JORDAN MD
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1008 16TH AVENUE
Practice Address - Street 2:SUITE 100 H JAMES JORDAN MD
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701
Practice Address - Country:US
Practice Address - Phone:907-456-4825
Practice Address - Fax:907-456-4899
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AKAK1093208000000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice