Geroski, Jordan

Geroski, Jordan is an individual health care provider with primary practice located at 611 E Douglas Rd Ste 137 , Mishawaka IN 46545-1464. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is her primary health care specialty. Geroski, Jordan can be contacted via phone (574) 335-6214.

Contact Information

Primary practice address
611 E Douglas Rd Ste 137 Mishawaka IN 46545-1464
Phone: (574) 335-6214
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02006037A Indiana
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 02006037A Indiana

Profile Details

NPI number 1265962633
LBN Legal business name Geroski, Jordan
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2017
Last updated Jun 25th, 2021 - about 3 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 1265962633 NPPES
Indiana Other 11019303A STATE LICENSE
Indiana MEDICAID 300004615 STATE LICENSE

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