JORDAN LICATA DO NPI 1952795106

NPI Details

Jordan Licata, DO is an otolaryngology in Tullahoma, TN with 3 years of experience. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. Jordan Licata, DO NPI is 1952795106. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year:2023

The provider's business location address is:

1821 N WASHINGTON ST
TULLAHOMA, TN
ZIP 37388-221
Phone: (931) 461-5056
Fax: (931) 455-4450

The NPI 1952795106 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 3/26/2015 and was last updated on 12/12/2024.

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: