Provider Demographics
NPI:1902465735
Name:MEYERS, JORDAN GENE (MD)
Entity type:Individual
Prefix:MR
First Name:JORDAN
Middle Name:GENE
Last Name:MEYERS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 LIBERTY SQ # 6049
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-5800
Mailing Address - Country:US
Mailing Address - Phone:857-244-0119
Mailing Address - Fax:855-651-0589
Practice Address - Street 1:6 LIBERTY SQ # 6049
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-5800
Practice Address - Country:US
Practice Address - Phone:857-244-0119
Practice Address - Fax:855-651-0589
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-05
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012852872084P0800X
WAMD614681872084P0800X
PAMD4892872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry