Individual
DR. GREGORY N TJOSSEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
123 5TH AVE SE, SPRING GROVE, MN 55974-1318
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40179
MN
207Q00000X
Family Medicine Physician
DR.0053297
CO
207Q00000X
Family Medicine Physician
MD156481
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026769
KAISER COMMERCIAL NUMBER
CO
05
—
500641868
—
OR
05
—
82389349
—
CO
Enumeration date
06/13/2005
Last updated
11/09/2020
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