Jordan, Douglas A

Jordan, Douglas A is an individual health care provider with primary practice located at 11528 Us Highway 19 , Port Richey FL 34668-1442. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Jordan, Douglas A can be contacted via phone (727) 868-2151.

Contact Information

Primary practice address
11528 Us Highway 19 Port Richey FL 34668-1442
Phone: (727) 868-2151
Fax: (727) 868-7379
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PO 2114 Florida
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X PO 2114 Florida

Profile Details

NPI number 1518945500
LBN Legal business name Jordan, Douglas A
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2006
Last updated Nov 30th, 2009 - about 17 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 1518945500 NPPES
Florida Other 102751 AVMED
Florida Other 10593101 AVMED
Florida Other 480018908 AVMED
Florida Other 65211 AVMED
Florida Other 985373 AVMED
Florida Other 01352 AVMED
Florida Other 10593102 AVMED
Florida MEDICAID 057053200 AVMED
Florida Other 6200309 AVMED

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