Individual
JORDAN BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
111 W STONE DR STE 110, KINGSPORT, TN 37660-6027
(423) 224-3701
(423) 224-3709
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 952-2111
(423) 282-1657
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110004691
VA
363A00000X
Physician Assistant
Primary
2436
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659701696
—
VA
05
—
Q003860
—
TN
Enumeration date
11/12/2013
Last updated
02/22/2025
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