Provider Demographics
NPI:1194384990
Name:HARKLESS, JOURDAN (DO)
Entity Type:Individual
Prefix:
First Name:JOURDAN
Middle Name:
Last Name:HARKLESS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JOURDAN
Other - Middle Name:A
Other - Last Name:HARKLESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7500 STATE RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-2439
Mailing Address - Country:US
Mailing Address - Phone:513-233-6439
Mailing Address - Fax:513-624-3284
Practice Address - Street 1:7500 STATE RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-2439
Practice Address - Country:US
Practice Address - Phone:513-233-6439
Practice Address - Fax:513-624-3284
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-11621207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine