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NPI Code Detail

MEDICARE: JORDAN SHEA HUNT PA-C

MEDICARE: JORDAN SHEA HUNT 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
1363A00000XPhysician Assistant0010-14488NC

General Provider Information

NPI Number : 1306679329
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN SHEA HUNT PA-C
Provider Business Mailing Address
First Line : 2602 LAMB RD
Second Line :
City : LEXINGTON
State : NC
Zip : 27295-5216
Country : US
Telephone Number : 336-309-6983
Fax Number :
Provider Business Practice Location Address
First Line : 269 S MAIN ST
Second Line :
City : NORWOOD
State : NC
Zip : 28128-6435
Country : US
Telephone Number : 980-323-5470
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2024
Last Update Date : 09/08/2024

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Directions to “ JORDAN SHEA HUNT PA-C” Practice Location

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