Individual
DR. GARY F JEZNACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
118 MAIN ST, STURBRIDGE, MA 01566-1533
(508) 347-5755
(508) 347-5702
Mailing address
118 MAIN ST, STURBRIDGE, MA 01566-1533
(508) 347-5755
(508) 347-5702
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
49792
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6172873
—
MA
Enumeration date
09/14/2005
Last updated
06/18/2008
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