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Contact Information

JORDAN MOODY
811 POLO RD APT 616
COLUMBIA, SC29223-4445
 Phone: 803-586-2132
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2083S0010X 84 Physician/Preventive Medicine
Indicates primary specialty

NPI Profile & details for JORDAN MOODY · (Male)

NPI # 1629577549
Status Active
Credentials
Entity Individual
Enumeration date 02/06/2018
Last updated 02/06/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • SC License # SC500634
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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