Individual
TENEISHA SHAVAUGH JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
410 UNIVERSITY PARKEAY, 1550A, AIKEN, SC 29801
(803) 306-7733
Mailing address
P.O. BOX 2162, GROVETOWN, GA 30813-0310
(713) 551-6523
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
84336
GA
207Q00000X
Family Medicine Physician
Primary
95139
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84336
GEORGIA MEDICAL LICENSE
GA
Enumeration date
07/08/2018
Last updated
05/07/2026
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