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:
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Health care specialties

SpecialtyCodeLicense #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 10 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 1669477071 NPPES
Oregon MEDICAID 0288531
Oregon MEDICAID 1669477071

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