Provider Demographics
NPI:1982845921
Name:JORDAN, ADRIENNE C (MD)
Entity type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:C
Last Name:JORDAN
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:7835 PARAGON RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4021
Mailing Address - Country:US
Mailing Address - Phone:800-532-3232
Mailing Address - Fax:
Practice Address - Street 1:7835 PARAGON RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4021
Practice Address - Country:US
Practice Address - Phone:800-532-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-22
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01093970A207ZP0102X
MIEMC0005318207ZP0102X
NY276650207ZP0102X
KYTP893207ZP0102X
WV29457207ZP0102X
OH35.129358207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology