Jordan, Gina Y

Jordan, Gina Y is an individual health care provider with primary practice located at 27 Kemmerlin Lane , Beaufort SC 29907-3402. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / Emergency Medical Services is her primary health care specialty. Jordan, Gina Y can be contacted via phone (843) 524-2100.

Contact Information

Primary practice address
27 Kemmerlin Lane Beaufort SC 29907-3402
Phone: (843) 524-2100
Fax: (843) 525-9613
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 24049 South Carolina
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 24049 South Carolina

Profile Details

NPI number 1225032741
LBN Legal business name Jordan, Gina Y
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Aug 30th, 2019 - about 6 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 1225032741 NPPES
Other 57 1060903 TAX ID
MEDICAID GP1566 TAX ID

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