# JORDAN PHYSICIAN ASSOCIATES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538145131
- **Authorized official:** MR. KEVIN COUGHLIN (PRESIDENT)
- **Authorized official phone:** (508) 746-2000

## Contact information

- **Practice address:** 275 SANDWICH ST, PLYMOUTH, MA 02360-2183
- **Practice address phone:** (508) 830-2401
- **Practice address fax:** (508) 830-1131
- **Mailing address:** 36 CORDAGE PARK CIR, SUITE 317, PLYMOUTH, MA 02360-7331
- **Mailing address phone:** (508) 830-2428
- **Mailing address fax:** (508) 830-2502

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | — |
| 207RH0003X | Hematology & Oncology Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | NULL | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | — |
| 2086S0129X | Vascular Surgery Physician | — | — | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 12/16/2005
- **Last updated:** 12/15/2021