Provider Demographics
NPI:1053362574
Name:JORDAN, CHRISTOPHER SHANNON (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:SHANNON
Last Name:JORDAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:200 MIFFLIN AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1982
Mailing Address - Country:US
Mailing Address - Phone:570-342-3145
Mailing Address - Fax:570-344-1309
Practice Address - Street 1:200 MIFFLIN AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1982
Practice Address - Country:US
Practice Address - Phone:570-342-3145
Practice Address - Fax:570-344-1309
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2022-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01061966A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology