Jordan, Thomas Edison

Jordan, Thomas Edison is an sole proprietor health care provider with primary practice located at 197 Ridge Rd , Jupiter FL 33477-9660. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Jordan, Thomas Edison can be contacted via phone (561) 339-7205.

Contact Information

Primary practice address
197 Ridge Rd Jupiter FL 33477-9660
Phone: (561) 339-7205
Fax: (561) 746-7297
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ME59988 Florida
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 4301060662 Michigan
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 52715 Massachusetts

Profile Details

NPI number 1831192293
LBN Legal business name Jordan, Thomas Edison
Credentials M.D., M.P.H.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 31st, 2005
Last updated Jan 16th, 2011 - about 13 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 1831192293 NPPES
Florida MEDICAID 266699500

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