Provider Demographics
NPI:1184039646
Name:BIERMAN, JORDAN TODD (OD)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:TODD
Last Name:BIERMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3697 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-4965
Mailing Address - Country:US
Mailing Address - Phone:614-699-6757
Mailing Address - Fax:614-754-5152
Practice Address - Street 1:81 E GAY ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-3103
Practice Address - Country:US
Practice Address - Phone:614-224-2414
Practice Address - Fax:614-754-5152
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6266152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist