Provider Demographics
NPI:1730417338
Name:TRAN, JORDAN LE (MD)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:LE
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3038 VALLEY AVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2637
Mailing Address - Country:US
Mailing Address - Phone:540-508-0651
Mailing Address - Fax:540-585-4081
Practice Address - Street 1:125 PROSPERITY DR
Practice Address - Street 2:SUITE 500
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-5385
Practice Address - Country:US
Practice Address - Phone:540-508-0651
Practice Address - Fax:540-508-0841
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2021-01-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101256096207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVVH748F896Medicare PIN