Individual
PHILIP ALTON JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 PATEWOOD DR STE C100, GREENVILLE, SC 29615-6322
(864) 454-7422
(864) 454-8265
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 695-6697
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4651
SC
363AS0400X
Surgical Physician Assistant
4651
SC
Other
Enumeration date
10/24/2022
Last updated
11/11/2024
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