So, Jason S

So, Jason S is an individual health care provider with primary practice located at 350 Peller Rd , Lake Geneva WI 53147-4543. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. So, Jason S can be contacted via phone (262) 245-0221.

Contact Information

Primary practice address
350 Peller Rd Lake Geneva WI 53147-4543
Phone: (262) 245-0221
Fax: (262) 249-0633
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036119919 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 63015-21 Wisconsin

Profile Details

NPI number 1508078643
LBN Legal business name So, Jason S
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2007
Last updated Aug 29th, 2019 - about 5 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 1508078643 NPPES
Wisconsin Other 1508078643 BCBSWI
Wisconsin Other SOJAS BCBSWI
Wisconsin MEDICAID 1508078643 BCBSWI

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