De Vries, Jason G

De Vries, Jason G is an individual health care provider with primary practice located at 1111 Bayshore Dr , Manitowoc WI 54220-5548. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Podiatrist. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. De Vries, Jason G can be contacted via phone (920) 682-6376.

Contact Information

Primary practice address
1111 Bayshore Dr Manitowoc WI 54220-5548
Phone: (920) 682-6376
Fax: (920) 652-0115
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 940-025 Wisconsin
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 940-25 Wisconsin
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 940 Wisconsin

Profile Details

NPI number 1609028422
LBN Legal business name De Vries, Jason G
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2008
Last updated Apr 10th, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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