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Individual

PHILLIP JORDAN DEAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1100 S JACKSON HWY, SUITE 104, SHEFFIELD, AL 35660-5769
(256) 381-8811
(256) 381-5677
Mailing address
930 FRANKLIN ST SE, HUNTSVILLE, AL 35801-4312
(256) 519-8104
(256) 519-8327

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
30609
AL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30609
ALABAMA LICENSE
01
34344
MEDICAL LICENSE
SC
Enumeration date
05/07/2009
Last updated
07/16/2015
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