Jordan Licata, DO
Jordan Licata, DO is an Otolaryngology in Tullahoma, Tennessee. Graduated from Philadelphia College of Osteopathic Medicine in 2023, 3 years ago. Practices with Marvel Clinic PC, a 6-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Kentucky and Tennessee.
- Years since qualifying
- 3
- Trained at
- Philadelphia College of Osteopathic Medicine
- Licensed in
- KY, TN
- In the registry since
- 2015
- Specialties on file
- 2
What do these letters mean?
- DO — Doctor of Osteopathic Medicine
- A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.
Practice location Address checks out
1821 N Washington StTullahoma, TN 37388-2221
Phone: (931) 461-5056
Fax: (931) 455-4450
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 1011 S Main St, Hopkinsville, KY 42240-2009 — (270) 881-1525
Specialties & licences
| Otolaryngology Physician (primary) | Taxonomy 207Y00000X · Licence 5294 (TN) |
|---|---|
| Otolaryngology Physician | Taxonomy 207Y00000X · Licence 05799 (KY) |
Record details
| NPI number | 1952795106 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | DO |
| Sole proprietor | No |
| NPI enumerated | March 26, 2015 |
| Last updated in NPPES | December 12, 2024 |
| Certification date | December 12, 2024 |
| Mailing address | 1821 N Washington St, Tullahoma, TN 37388-2221 |
Medicare enrollment
| Medicare specialty | OTOLARYNGOLOGY |
|---|---|
| Medical school | PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduated | 2023 (3 years in practice) |
| Group practice | Marvel Clinic P.C. — 6 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |