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Contact Information

ROBERT JORDAN
8954 HOSPITAL DR
DOUGLASVILLE, GA30134
 Phone: 770-920-6420
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for ROBERT JORDAN · (Male)

NPI # 1326149063
Status Active
Credentials
Entity Individual
Enumeration date 09/26/2006
Last updated 09/04/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 001968
  • GA Medicaid PENDING
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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