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Organization
JEROME WH NISWONGER MD INC
Active
Organization
JEROME WH NISWONGER MD INC
Active
Other names
Eye Life Institute
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME NISWONGER M.D. (OWNER)
(530) 877-2020
Entity
Organization
Contact information
Practice address
245 N VILLA AVE, WILLOWS, CA 95988-2607
(530) 877-2020
(530) 877-4641
Mailing address
6283 CLARK RD, STE. 10, PARADISE, CA 95969-4100
(530) 877-2020
(530) 877-4641
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
07/14/2008
Last updated
07/14/2008
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