Individual
JORDAN OWEN GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
890 W FARIS RD STE 550, GREENVILLE, SC 29605-4286
(864) 455-6800
(864) 455-6825
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4843
SC
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
12/17/2019
Last updated
05/17/2023
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