Joseph Jon Deboer PA-C

NPI 1053608828 - Physician Assistant - 363A00000X

NPI Details
NPI 1053608828
Gender Male
Enumeration Date 06/30/2011
Last Updated 09/27/2013
Entity Type Individual
Active Over 6 years ago
Practice Location
430 E DIVISION ST
FOND DU LAC WI, 54935-4560, US
Phone (920) 929-2300
Fax
Business Location
430 E DIVISION ST
FOND DU LAC WI, 54935-4560, US
Phone (920) 926-4602
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Wisconsin
License Number 2785-023
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According to our database, Mr. Joseph Jon Deboer PA-C NPI is 1053608828, taxonomy code is 363A00000X and license number is 2785-023, license state is located at Wisconsin. Joseph Jon Deboer PA-C physically located at 430 E Division St, Fond Du Lac WI, 54935-4560. NPI Number Joseph Jon Deboer PA-C has the Individual type.

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1053608828 NPI number is provided on an as is basis without warranty of any kind. 1053608828 is maintained by the National Plan & Provider Enumeration System. The contents of Joseph Jon Deboer PA-C are for informational purposes only.