Jordan, Guy W

Jordan, Guy W is an sole proprietor health care provider with primary practice located at 1566 Thompson Bridge Rd , Gainesville GA 30501-1714. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as his primary health care specialty. Jordan, Guy W can be contacted via phone (770) 534-5262.

Contact Information

Primary practice address
1566 Thompson Bridge Rd Gainesville GA 30501-1714
Phone: (770) 534-5262
Fax: (770) 534-3224
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X PSY000863 Georgia

Profile Details

NPI number 1780773812
LBN Legal business name Jordan, Guy W
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 12th, 2006
Last updated Feb 25th, 2013 - about 12 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 1780773812 NPPES
Georgia MEDICAID 000289198A

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