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Contact Information

JORDAN DEVELOPMENTAL PEDIATRICS PC
21031 N CAVE CREEK RD
STE F4
PHOENIX, AZ85024-5525
 Phone: 602-956-3141
 Fax: 602-795-1671
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Developmental - Behavioral Pediatrics

2080P0006X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for JORDAN DEVELOPMENTAL PEDIATRICS PC

NPI Number 1649229394
LBN Legal business name JORDAN DEVELOPMENTAL PEDIATRICS PC
Authorized official TIMOTHY JORDAN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/09/2006
Last updated 04/18/2008 - About 18 years ago
Identifiers
AZ License # 26988
AZ Medicaid 508658
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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