Individual
DR. JERRY VARGHESE THUTHIKATTU JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 S MAIN ST STE 150, JAMESTOWN, NY 14701-6627
(716) 483-6700
(716) 664-7275
Mailing address
2400 W VILLARD AVE, MILWAUKEE, WI 53209-4901
(414) 527-8191
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
325117
NY
207Q00000X
Family Medicine Physician
77253-20
WI
Other
Enumeration date
07/29/2020
Last updated
08/03/2023
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