Individual
MR. JORDAN ROMNEY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
280 S PACIFIC HWY, TALENT, OR 97540-6649
(304) 520-6644
(541) 414-0415
Mailing address
650 WOODLARK DR, MEDFORD, OR 97501-2625
(206) 306-5107
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA214334
OR
Other
Enumeration date
03/24/2023
Last updated
03/16/2026
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