Organization
JORDAN PHYSICIAN ASSOCIATES, INC.
Active
Parent organization
JORDAN PHYSICIAN ASSOCIATES, INC.
Other names
BIDH-Plymouth Pathology
Organization subpart
Yes
Provider details
NPI number
Legal business name
JORDAN PHYSICIAN ASSOCIATES, INC.
Authorized official
CATHERINE J GREY (CREDENTIALING SPECIALIST)
(508) 830-2401
Entity
Organization
Contact information
Practice address
275 SANDWICH ST, PLYMOUTH, MA 02360-2183
(508) 830-2466
Mailing address
275 SANDWICH ST, PLYMOUTH, MA 02360-2183
(508) 746-2000
(508) 830-1131
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110072193Z
—
MA
Enumeration date
02/09/2017
Last updated
02/19/2020
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