Basic Information
| Provider Information | |||||||||
| NPI: | 1023371366 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OCHSNER | ||||||||
| FirstName: | JORDAN | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1061 HARMON AVE STE 1D03 | ||||||||
| Address2: | WINN ARMY COMMUNITY HOSPITAL | ||||||||
| City: | FORT STEWART | ||||||||
| State: | GA | ||||||||
| PostalCode: | 313145641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9124356633 | ||||||||
| FaxNumber: | 9157422653 | ||||||||
| Practice Location | |||||||||
| Address1: | 1061 HARMON AVE STE 1D03 | ||||||||
| Address2: | WINN ARMY COMMUNITY HOSPITAL | ||||||||
| City: | FORT STEWART | ||||||||
| State: | GA | ||||||||
| PostalCode: | 313145641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9124356633 | ||||||||
| FaxNumber: | 9157422653 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2012 | ||||||||
| LastUpdateDate: | 09/18/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 0101254956 | VA | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.