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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