Dr. Jordan Lee Wallin
Otolaryngologist (ENT Doctor) Facial Plastic Surgeon
446 S Mall Dr Ste B1
St George
, Utah 84790-4945
Dr. Jordan Lee Wallin
Otolaryngologist (ENT Doctor) Facial Plastic Surgeon
446 S Mall Dr Ste B1
St George
, Utah 84790-4945
(435) 580-4028
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About
Features
Specialties
- Otolaryngologist (ENT Doctor)
- Facial Plastic Surgeon
Languages spoken
- English
Location
First Address
- Dr. Jordan Lee Wallin
- 446 S Mall Dr Ste B1
- St George, UT
- Zip : 84790-4945
- Fax : (435) 580-4028
- Phone : (435) 627-8150
Second Address
- Dr. Jordan Lee Wallin
- 446 S Mall Dr Ste B1
- St George, UT
- Zip : 84790-4945
- Fax : (435) 580-4028
- Phone : (435) 627-8150
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207Y00000X | Otolaryngologist (ENT Doctor) | 2008-01743 | NC |
| Y | 207YS0123X | Facial Plastic Surgeon | 2008-01743 | NC |
National Provider Identifier
| NPI | 1811177652 |
|---|---|
| Provider Name | Dr. Jordan Lee Wallin |
| First Address | St George, UT 84790-4945 |
| Second Address | St George, UT 84790-4945 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/11/2007 |
| Last Update Date | 23/10/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.