Individual
JORDAN DEAN PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-4418
(352) 273-8610
Mailing address
2816 SMILING HILL BLVD, EDMOND, OK 73013-6402
(405) 249-8668
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME161545
FL
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
ME161545
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118393100
—
FL
Enumeration date
04/09/2018
Last updated
08/31/2023
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