Individual
DR. JAN PETRASEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
5201 HARRY HINES BLVD, GRADUATE MEDICAL EDUCATION, DALLAS, TX 75235-7708
(214) 590-8058
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-4775
(601) 815-0434
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
27717
MS
207RG0100X
Gastroenterology Physician
27717
MS
207RG0100X
Gastroenterology Physician
Primary
Q8602
TX
390200000X
Student in an Organized Health Care Education/Training Program
BP10047494
TX
Other
Enumeration date
04/30/2013
Last updated
02/17/2025
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