Jordan Wilson, PA-C
Physician Assistant in Raynham, Massachusetts
1235651720- Practice location
- 100 New State Hwy, Raynham, MA 02767-5423
- Phone
- 781-666-2711
- Fax
- 781-666-2712
- Last updated
- March 12, 2025
Jordan Wilson is a Physician Assistant based in Raynham, MA. Jordan Wilson practices in Raynham, MA and has the professional credentials of PA-C. The NPI Number for Jordan Wilson is 1235651720 and holds a License No. 9110440 (FL). The current practice location address for Jordan Wilson is 100 New State Hwy, Raynham, MA 02767-5423 and can be reached out via phone at 781-666-2711 and via fax at 781-666-2712.
Provider Profile Details
- NPI Number
- 1235651720
- Provider Name
- Jordan Wilson
- Credential
- PA-C
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 100 New State Hwy, Raynham, MA 02767-5423
- Phone Number
- 781-666-2711
- Fax Number
- 781-666-2712
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- July 17, 2017
- Last Update Date
- March 12, 2025
- Certification Date
- March 12, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 100 New State Hwy
Raynham, MA 02767-5423 - City
- Raynham
- State
- Massachusetts
- Zip
- 02767-5423
- Phone Number
- 781-666-2711
- Fax Number
- 781-666-2712
Provider Business Mailing Address Details
- Address
- 100 New State Hwy
Raynham, MA 02767-5423 - City
- Raynham
- State
- MA
- Zip
- 02767-5423
- Phone Number
- 781-666-2711
- Fax Number
- 781-666-2712
License Information
- License Number (1)
- 9110440
- License State (1)
- FL
- Taxonomy (1)
- Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry · 2084B0040X
- License Number (2)
- PA60855409
- License State (2)
- WA
- Taxonomy (2)
- Physician Assistant · 363A00000X
- License Number (3)
- PA101388
- License State (3)
- MA
- Taxonomy (3)
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Jordan Wilson, PA-C?
The NPI number of Jordan Wilson, PA-C is 1235651720. It was assigned on July 17, 2017 and is currently active in the NPPES registry.
What is the specialty of Jordan Wilson, PA-C?
Jordan Wilson, PA-C is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in FL under license number 9110440.
Where does Jordan Wilson, PA-C practice?
The practice location is 100 New State Hwy, Raynham, MA 02767-5423. The office can be reached at 781-666-2711 (phone) or 781-666-2712 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1235651720 directly on the NPPES registry website.