Desjardin, Robert Leo

Desjardin, Robert Leo is an individual health care provider with primary practice located at 1818 N Meade St Suite 240 West, Appleton WI 54911-3454. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Desjardin, Robert Leo can be contacted via phone (920) 731-8289.

Contact Information

Primary practice address
1818 N Meade St Suite 240 West Appleton WI 54911-3454
Phone: (920) 731-8289
Fax: (920) 832-0444
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 49 023 Wisconsin

Profile Details

NPI number 1942292198
LBN Legal business name Desjardin, Robert Leo
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2005
Last updated Jul 8th, 2007 - about 17 years 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1942292198 NPPES
Wisconsin MEDICAID 42901200

Popular Providers