Randall W Jordan OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1192 Issued in GA

Legal business name

RANDALL W JORDAN OD PC

Practice address

1107 E South Greer Street
Cordele, GA 31015

Phone

(229) 273-0018

Fax

(229) 273-0102

NPI assigned

Sep 25, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Randall W Jordan, OD

Title

President

Phone

(229) 273-0018

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377820800000",
    "number": "1811098767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5103",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310105103",
            "telephone_number": "229-273-0018",
            "fax_number": "229-273-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 E SOUTH GREER STREET",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "31015",
            "telephone_number": "229-273-0018",
            "fax_number": "229-273-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALL W JORDAN OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2013-08-30",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-273-0018",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00414455F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• R W Leitner OD LLC (Leitner Eye Care)
• Radiology Associates of Cordele
• Rahhal Gastroenterology Associates, PC
• Tasha Rahman
• Tina B Rainey, OTR/L
• Adasha Redding
• Alicia Roberts Register, MD
• Haley Strange Revell, FNP
• Nancy Parker Rigdon
• Guido H Ring, MD

• Optometrist in Cordele, GA
• Providers in Cordele, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.