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Individual

JEFFREY BRYAN VANDEUSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., PH.D.

Contact information

Practice address
269 PORTLAND WAY S, GALION, OH 44833-2312
(419) 462-3470
(419) 468-5184
Mailing address
700 N COLUMBUS ST, CRESTLINE, OH 44827-1455
(419) 462-3485
(419) 468-5184

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
098460
OH
207RH0003X
Hematology & Oncology Physician
134714
NC
207RX0202X
Medical Oncology Physician
Primary
35098460
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0067884
OH
Enumeration date
05/02/2008
Last updated
01/22/2025
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