Individual
MR. JERMAHL DAVID MCKISSICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10651 E ST, NAVAL HEALTH CLINIC CORPUS CHRISTI TX, CORPUS CHRISTI, TX 78419-5130
(559) 513-1586
Mailing address
10651 E ST, NAVAL HEALTH CLINIC CORPUS CHRISTI TX, CORPUS CHRISTI, TX 78419-5130
(559) 513-1586
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1091561
NE
Other
Enumeration date
06/02/2010
Last updated
06/02/2010
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