Tate, Jordan Lee

Tate, Jordan Lee is an individual health care provider with primary practice located at 1101 Old Philadelphia Rd Ste G , Jasper GA 30143-4069. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is her primary health care specialty. Tate, Jordan Lee can be contacted via phone (678) 971-4167.

Contact Information

Primary practice address
1101 Old Philadelphia Rd Ste G Jasper GA 30143-4069
Phone: (678) 971-4167
Fax: (833) 989-2501
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X STUDENT Georgia
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 003916 Georgia
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X ME115895 Florida
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 72139 Georgia

Profile Details

NPI number 1508008079
LBN Legal business name Tate, Jordan Lee
Credentials M.D., MPH
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2009
Last updated May 13th, 2022 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508008079 NPPES
Georgia MEDICAID 003150702

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