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PHILLIP JORDAN DEAN M.D.

>> Organized Health Care Education/Training Program >> Student

Registrant NPI Number: 1245464114

Individual Registrant:
 PHILLIP JORDAN DEAN M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1100 S JACKSON HWY SUITE 104 SHEFFIELD, AL 35660-5769 US
Tel: 256-381-8811  Fax: 256-381-5677

Contact information for business:
930 FRANKLIN ST SE  HUNTSVILLE, AL 35801-4312 US
Tel: 256-519-8104  Fax: 256-519-8327

Registration Information:
NPI: 1245464114
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N390200000XStudent
Organized Health Care Education/Training Program
Y207RC0000XAllopathic & Osteopathic Physicians
Internal Medicine
AL30609

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
ALABAMA LICENSE3060901
MEDICAL LICENSE34344SC01




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