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NPI Code Detail

MEDICARE: DAMON M JORDAN PA-C

MEDICARE: DAMON M JORDAN PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant130316IA
2363AS0400XSurgical Physician AssistantPA458ME
3363A00000XPhysician Assistant130316IA

General Provider Information

NPI Number : 1033109707
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAMON M JORDAN PA-C
Provider Business Mailing Address
First Line : 701 W FOREVERGREEN RD
Second Line :
City : NORTH LIBERTY
State : IA
Zip : 52317-9848
Country : US
Telephone Number : 319-356-2223
Fax Number : 319-353-6745
Provider Business Practice Location Address
First Line : 701 W FOREVERGREEN RD
Second Line :
City : NORTH LIBERTY
State : IA
Zip : 52317-9848
Country : US
Telephone Number : 319-356-2223
Fax Number : 319-353-6745
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2005
Last Update Date : 05/27/2025

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Directions to “ DAMON M JORDAN PA-C” Practice Location

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