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Individual

JORDAN TAYLOR MEATON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, PA-C

Contact information

Practice address
3024 NEW BERN AVE, RALEIGH, NC 27610-1247
(919) 350-5318
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-2266
(919) 350-7687

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-12428
NC
363A00000X
Physician Assistant
085.005561
IL
363AM0700X
Medical Physician Assistant
0010-12428
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1750757662
NC
Enumeration date
08/14/2015
Last updated
03/03/2023
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