| Marshall C Jordan, MD | |
|
Espanola Multi-specialty Clinic, 1010 Spruce St, Espanola, NM 87532 | |
| (505) 367-0340 | |
| (505) 367-0346 |
| Full Name | Marshall C Jordan |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | Espanola Multi-specialty Clinic, Espanola, New Mexico |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982656880 | NPI | - | NPPES |
| 29377056 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | MD2006-0824 (New Mexico) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Marshall C Jordan, MD Po Box 26666, Phs Provider Enrollment, Albuquerque, NM 87125-6666 Ph: (505) 923-5356 | Marshall C Jordan, MD Espanola Multi-specialty Clinic, 1010 Spruce St, Espanola, NM 87532 Ph: (505) 367-0340 |
Mr. Blair Kent Hough, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1010 Spruce St, Pmg Espanola, Espanola, NM 87532 Phone: 505-367-0362 | |
Dr. Antonio Thomas Brecevich, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1010 Spruce St 3rd Floor Area 4, General Surgery, Espanola, NM 87532 Phone: 505-367-0340 Fax: 505-367-0346 |