Individual
DR. JEFF J TAVASSOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5202
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5202
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
52227
WI
207X00000X
Orthopaedic Surgery Physician
OS 10434
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64340
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/02/2006
Last updated
11/17/2022
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