Individual
MR. JASON ORRIN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2021 S WEBSTER AVE, GREEN BAY, WI 54301-2257
(920) 965-0345
(920) 273-6011
Mailing address
5982 MARIBEL RD, DENMARK, WI 54208-8901
(401) 480-1993
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3057-023
WI
Other
Enumeration date
09/01/2011
Last updated
11/24/2014
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