Emmons, Jerry Robert

Emmons, Jerry Robert is an individual health care provider with primary practice located at 110 W 6Th St , Oswego NY 13126-2507. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Emmons, Jerry Robert can be contacted via phone (315) 313-4631.

Contact Information

Primary practice address
110 W 6Th St Oswego NY 13126-2507
Phone: (315) 313-4631
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 258495 New York

Profile Details

NPI number 1528202462
LBN Legal business name Emmons, Jerry Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2009
Last updated Oct 10th, 2016 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528202462 NPPES
New York MEDICAID 03341462

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