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 |
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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 |
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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 |
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Provider Enumeration Date | 08/16/2012 |
Last Update Date | 09/04/2012 |
Identifier | Type | State | Issuer |
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1972851384 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 033367 (Georgia) | Primary |