Individual
JASON R OUELLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
56 FRANKLIN ST, WATERBURY, CT 06706-1221
(203) 709-8828
(203) 709-3518
Mailing address
56 FRANKLIN ST, 3RD FLOOR, WATERBURY, CT 06706-1221
(203) 709-8873
(203) 709-8689
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
042496
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001424960
—
CT
01
—
010042496CT01
ANTHEM BCBS CT
CT
01
—
042496
CONNECTICARE
CT
01
—
24-50636
AMERICHOICE
CT
01
—
2V5800
HEALTHNET/COMMERCIAL
CT
01
—
3679667/7030649
AETNA
CT
01
—
368650
WELLCARE
CT
01
—
959905
USA
CT
01
—
P3408258
OXFORD
CT
01
—
PENDING
RR MEDICARE
CT
Enumeration date
06/30/2006
Last updated
07/15/2014
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