Jenison, Eric L.
Jenison, Eric L. is an individual health care provider with primary practice located at 704 S Webster Ave Suite 100, Green Bay WI 54301-3528. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Gynecologic Oncology. Allopathic & Osteopathic Physicians / Gynecologic Oncology is his primary health care specialty. Jenison, Eric L. can be contacted via phone (920) 433-3430.Contact Information
Primary practice address
704 S Webster Ave Suite 100
Green Bay WI 54301-3528
Phone: (920) 433-3430
Fax: (920) 432-6313
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 038252 | Ohio |
Allopathic & Osteopathic Physicians / Gynecologic Oncology | 207VX0201X | 59856 | Wisconsin |
Profile Details
NPI number | 1669477071 |
---|---|
LBN Legal business name | Jenison, Eric L. |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 14th, 2005 |
Last updated | Sep 18th, 2014 - about 11 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1669477071 | NPPES |
Oregon | MEDICAID | 0288531 | |
Oregon | MEDICAID | 1669477071 |
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