Dodge, Jordan Richard

Dodge, Jordan Richard is an individual health care provider with primary practice located at 600 N Pickaway St , Circleville OH 43113-1447. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Dodge, Jordan Richard can be contacted via phone (614) 566-8333.

Contact Information

Primary practice address
600 N Pickaway St Circleville OH 43113-1447
Phone: (614) 566-8333
Fax: (614) 566-5189
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN.CNP.17030 Ohio

Profile Details

NPI number 1275923203
LBN Legal business name Dodge, Jordan Richard
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 29th, 2015
Last updated Mar 28th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275923203 NPPES
Ohio MEDICAID 0118258

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