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MR. JORDAN TYLER FOULGER PA

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1417432063

Individual Registrant:
MR. JORDAN TYLER FOULGER PA
Gender: M
Not Sole Proprietor

Location and contact information for practice:
5994 S HOSPITAL DR  GLOBE, AZ 85501-9462 US
Tel: 928-425-7108  Fax: 928-425-7925

Contact information for business:
5994 S HOSPITAL DR  GLOBE, AZ 85501-9462 US
Tel: 928-425-7108  Fax: 928-425-7925

Registration Information:
NPI: 1417432063
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
AZ

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
AETNAW238629531AZ01




HEALTH CARE JOBS AZ - Page 1



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