Individual
JEREMY STAYTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1711 S STEPHENSON AVE STE 305, IRON MOUNTAIN, MI 49801-3650
(906) 776-5200
Mailing address
PO BOX 549, IRON MOUNTAIN, MI 49801-0549
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
125060385
IL
208600000X
Surgery Physician
Primary
4301111518
MI
Other
Enumeration date
12/06/2013
Last updated
01/07/2020
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