Individual
DR. JEFFREY STEVEN FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
816 D ST, APT 13, SACRAMENTO, CA 95814-0719
(952) 595-1100
(612) 294-4903
Mailing address
11995 SINGLETREE LN, STE 500, EDEN PRAIRIE, MN 55344-5347
(952) 595-1301
(612) 294-4903
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
12177
CA
2085R0202X
Diagnostic Radiology Physician
5101017332
MI
Other
Enumeration date
07/25/2007
Last updated
05/21/2014
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