Provider Demographics
NPI:1750939831
Name:WALKER, JORDAN ANDREW (PA-C)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:ANDREW
Last Name:WALKER
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:390 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:UMATILLA
Mailing Address - State:FL
Mailing Address - Zip Code:32784-9602
Mailing Address - Country:US
Mailing Address - Phone:352-669-3175
Mailing Address - Fax:352-669-3640
Practice Address - Street 1:390 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:UMATILLA
Practice Address - State:FL
Practice Address - Zip Code:32784-9602
Practice Address - Country:US
Practice Address - Phone:352-669-3175
Practice Address - Fax:352-669-3640
Is Sole Proprietor?:No
Enumeration Date:2019-08-31
Last Update Date:2023-06-16
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant