Provider Demographics
NPI:1730421819
Name:BALENCIC, JORDAN PAUL (DO)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:PAUL
Last Name:BALENCIC
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:25 N 32ND ST
Mailing Address - Street 2:MAIL CODE H039
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-2918
Mailing Address - Country:US
Mailing Address - Phone:717-730-9782
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:MAIL CODE H039
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-8903
Practice Address - Fax:717-531-5831
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2016-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS018254208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice