Provider Demographics
NPI:1104561901
Name:O'STEEN, JORDAN (MD)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:O'STEEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 N PLEASANTBURG DR STE 301
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-1258
Mailing Address - Country:US
Mailing Address - Phone:864-252-4808
Mailing Address - Fax:864-342-6962
Practice Address - Street 1:1120 N PLEASANTBURG DR STE 301
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-1258
Practice Address - Country:US
Practice Address - Phone:864-252-4808
Practice Address - Fax:864-342-6962
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC87916207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine