Jordan, Teneisha Shavaugh
Jordan, Teneisha Shavaugh is an individual health care provider with primary practice located at 300 E Hospital Rd , Fort Eisenhower GA 30905-5741. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Jordan, Teneisha Shavaugh can be contacted via phone (706) 787-5115.Contact Information
Primary practice address
300 E Hospital Rd
Fort Eisenhower GA 30905-5741
Phone: (706) 787-5115
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 84336 | Georgia |
Profile Details
| NPI number | 1558857045 |
|---|---|
| LBN Legal business name | Jordan, Teneisha Shavaugh |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 8th, 2018 |
| Last updated | Oct 31st, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558857045 | NPPES |
| Georgia | Other | 84336 | GEORGIA MEDICAL LICENSE |
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