DAMON M JORDAN PA-C NPI 1033109707

NPI Information

NPI: 1033109707
Provider Name: DAMON M JORDAN, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
49 SPRING ST
SCARBOROUGH, ME
ZIP 04074
Phone: (207) 885-0011
Get Directions

Damon M Jordan, PA-C is a surgical physician assistant in Scarborough, ME with 29 years of experience. Damon M Jordan, PA-C NPI is 1033109707. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: HAHNEMANN UNIVERSITY COLLEGE OF MEDICINE
Graduation Year:1995

The provider's business location address is:

49 SPRING ST
SCARBOROUGH, ME
ZIP 04074
Phone: (207) 885-0011
Fax: (207) 885-5851

The NPI 1033109707 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/25/2005 and was last updated on 1/24/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	PA458	MAINE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	P01116195	MEDICARE PIN	MAINE
2	AP067701	MEDICARE PIN
3	S08017	MEDICARE UPIN	MAINE
4	AP067705	MEDICARE PIN	MAINE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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