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NPI Code Detail

MEDICARE: BECKY JORDAN

MEDICARE: BECKY JORDAN
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
1174400000XSpecialistMD420034PA

General Provider Information

NPI Number : 1205809803
Entity Type Code : Individual
Provider Name (Legal Business Name) : BECKY JORDAN
Provider Business Mailing Address
First Line : 200 LOTHROP ST
Second Line : SUITE 9055 FORBES TOWER
City : PITTSBURGH
State : PA
Zip : 15213-2536
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7175 SALTSBURG RD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15235-2252
Country : US
Telephone Number : 412-795-7366
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2006
Last Update Date : 03/25/2021

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Directions to “ BECKY JORDAN ” Practice Location

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