Organization
QUINCY JORDAN MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. QUINCY J JORDAN MD (OWNER)
(877) 610-2791
Entity
Organization
Contact information
Practice address
2350 SOUTH HOUSTON LAKE RD, #902, KATHLEEN, GA 31047-5414
(877) 610-2791
Mailing address
PO BOX 2105, FORT VALLEY, GA 31030-2105
(877) 610-2791
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
033367
GA
Other
Enumeration date
08/16/2012
Last updated
09/04/2012
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