Provider Demographics
NPI:1265268874
Name:HANDSCHUMACHER, JORDAN
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:HANDSCHUMACHER
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 1:5315 KADE JOSEPH DR APT 106
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-8297
Mailing Address - Country:US
Mailing Address - Phone:614-657-7340
Mailing Address - Fax:
Practice Address - Street 1:5315 KADE JOSEPH DR APT 106
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-8297
Practice Address - Country:US
Practice Address - Phone:614-657-7340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
No175T00000XOther Service ProvidersPeer Specialist