JASON O DAVIS

NEW DERMATOLOGY GROUP LTD

Dr JASON O DAVIS is a male medical professional, specializing in Physician Assistant. He graduated in 2012.

Contact

NEW DERMATOLOGY GROUP LTD

3415 CUSTER ST
SUITE D
MANITOWOC
WI
542204328

Tel: 9209650345

JASON O DAVIS Information

Npi 1134400385
Pac Id 7416101464
Professional Enrollment Id I20130129000328
Last Name DAVIS
First Name JASON
Middle Name O
Suffix
Gender M
Credential
Medical School Name OTHER
Graduation Year 2012
Primary Specialty PHYSICIAN ASSISTANT
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name NEW DERMATOLOGY GROUP LTD
Group Practice Pac Id 9537312665
Number Of Group Practice Members 10
Line 1 Street Address 3415 CUSTER ST
Line 2 Street Address SUITE D
Marker Of Address Line 2 Suppression
City MANITOWOC
State WI
Zip Code 542204328
Phone Number 9209650345
Hospital Affiliation Ccn 1
Hospital Affiliation Lbn 1
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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