Individual
MICAH JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
225 CLEARFIELD AVE, VIRGINIA BEACH, VA 23462-1815
(757) 457-5100
(757) 961-3696
Mailing address
901 ENTERPRISE PKWY STE 900, HAMPTON, VA 23666-6250
(757) 827-2480
(757) 827-2566
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/25/2020
Last updated
03/25/2026
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