Healthcare Provider Details

I. General information

NPI: 1841721354
Provider Name (Legal Business Name): JORDAN CRAIG KUHN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2017
Last Update Date: 12/27/2021
Certification Date: 12/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 HOSPITAL DR STE 300&202
FREDERICKSBURG VA
22401-8451
US

IV. Provider business mailing address

10002 VESTAL PL
CORAL SPRINGS FL
33071-5827
US

V. Phone/Fax

Practice location:
  • Phone: 540-656-2830
  • Fax:
Mailing address:
  • Phone: 954-548-5014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101272022
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: