Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JORDAN LICATA, DO
ActiveJORDAN LICATA, DO is a Otolaryngology healthcare provider located in TULLAHOMA, Tennessee. NPI 1952795106 is currently active in the NPPES registry. Verify at CMS.
Otolaryngology · TULLAHOMA, TN
Registration Details
- NPI Number
- 1952795106
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 26, 2015 (11.372648200059 yrs)
- Last Updated
- Dec 12, 2024
- Licenses
-
05799 (KY)5294 (TN)
Practice Information
- Address
-
1821 N WASHINGTON STTULLAHOMA, TN, 373882221Browse TN providers · Browse ZIP 37388
- Phone
- 9314615056
- Fax
- 9314554450
- Primary Specialty
-
Otolaryngology
207Y00000X
- Additional Specialty
- Otolaryngology
Other Otolaryngology Providers in TULLAHOMA, TN
| Name | Credential | NPI |
|---|---|---|
| JEFFREY BLAINE MARVEL | M.D. | 1740285063 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.