Jordan, Douglas A
Jordan, Douglas A is an individual health care provider with primary practice located at 11528 Us Highway 19 , Port Richey FL 34668-1442. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Jordan, Douglas A can be contacted via phone (727) 868-2151.Contact Information
Primary practice address
11528 Us Highway 19
Port Richey FL 34668-1442
Phone: (727) 868-2151
Fax: (727) 868-7379
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | PO 2114 | Florida |
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | PO 2114 | Florida |
Profile Details
NPI number | 1518945500 |
---|---|
LBN Legal business name | Jordan, Douglas A |
Credentials | Doctor of Podiatric Medicine (DPM) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 9th, 2006 |
Last updated | Nov 30th, 2009 - about 15 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1518945500 | NPPES |
Florida | Other | 102751 | AVMED |
Florida | Other | 10593101 | AVMED |
Florida | Other | 480018908 | AVMED |
Florida | Other | 65211 | AVMED |
Florida | Other | 985373 | AVMED |
Florida | Other | 01352 | AVMED |
Florida | Other | 10593102 | AVMED |
Florida | MEDICAID | 057053200 | AVMED |
Florida | Other | 6200309 | AVMED |
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