Provus, Jason D
Provus, Jason D is an sole proprietor health care provider with primary practice located at 555 E Broadway Ave Ste 129 , Jackson WY 83001-8640. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Provus, Jason D can be contacted via phone (307) 733-3900.Contact Information
Primary practice address
555 E Broadway Ave Ste 129
Jackson WY 83001-8640
Phone: (307) 733-3900
Fax: (307) 739-7683
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 16633A | Wyoming |
Profile Details
| NPI number | 1972821320 |
|---|---|
| LBN Legal business name | Provus, Jason D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 10th, 2010 |
| Last updated | Mar 9th, 2024 - about last year |
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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