| Quincy Jordan MD LLC | |
|
2350 South Houston Lake Rd #902 Kathleen GA 31047-5414 | |
| (877) 610-2791 | |
| Not Available |
| Full Name | Quincy Jordan MD LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 2350 South Houston Lake Rd, Kathleen, Georgia |
| Authorized Official Name and Position | Quincy J Jordan (OWNER) |
| Authorized Official Contact | 8776102791 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Quincy Jordan MD LLC Po Box 2105 Fort Valley GA 31030-2105 Ph: (877) 610-2791 | Quincy Jordan MD LLC 2350 South Houston Lake Rd #902 Kathleen GA 31047-5414 Ph: (877) 610-2791 |
| NPI Number | 1972851384 |
|---|---|
| Provider Enumeration Date | 08/16/2012 |
| Last Update Date | 09/04/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972851384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 033367 (Georgia) | Primary |
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