Individual
DR. JERRY ROBERT EMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 W 6TH ST, OSWEGO, NY 13126-2507
(315) 313-4631
Mailing address
110 W 6TH ST, OSWEGO, NY 13126-2507
(315) 313-4631
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
258495
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03341462
—
NY
Enumeration date
04/22/2009
Last updated
10/10/2016
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