MR. JORDAN RILEY CORMACK PHYSICIAN ASSISTANT NPI 1548890247

NPI Information

MR. Jordan Riley Cormack, PHYSICIAN ASSISTANT is a medical physician assistant in Knoxville, TN with 5 years of experience. MR. Jordan Riley Cormack, PHYSICIAN ASSISTANT NPI is 1548890247. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1901 CLINCH AVE
KNOXVILLE, TN
ZIP 37916-307
Phone: (865) 541-1111

The NPI 1548890247 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 1/22/2020 and was last updated on 6/2/2022.

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:

Other Identifiers

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

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