Organization
JEFFERSON COUNTY PUBLIC HEALTH SERVICE
Active
Organization
JEFFERSON COUNTY PUBLIC HEALTH SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN A. JENNINGS (PUBLIC HEALTH DIRECTOR)
(315) 786-3715
Entity
Organization
Contact information
Practice address
531 MEADE ST, WATERTOWN, NY 13601-1225
(315) 786-3710
(315) 786-3761
Mailing address
531 MEADE ST, WATERTOWN, NY 13601-1225
(315) 786-3710
(315) 786-3761
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
2201200R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2201200R
OPERATING CERTIFICATE
NY
01
—
54558B
MEDICARE PART B
NY
Enumeration date
12/29/2006
Last updated
08/08/2025
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