Provider Demographics
NPI:1033723697
Name:SEAMANS, JORDAN SCOTT
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:SCOTT
Last Name:SEAMANS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7778 SCHOMBURG RD APT 610
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-1928
Mailing Address - Country:US
Mailing Address - Phone:706-660-3664
Mailing Address - Fax:
Practice Address - Street 1:7778 SCHOMBURG RD APT 610
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-1928
Practice Address - Country:US
Practice Address - Phone:706-660-3664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility