Individual
DR. JASON G DE VRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1111 BAYSHORE DR, MANITOWOC, WI 54220-5548
(920) 682-6376
(920) 652-0115
Mailing address
1035 KEPLER DR, GREEN BAY, WI 54311-8320
(920) 490-9046
(920) 405-8005
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
940
WI
213ES0103X
Foot & Ankle Surgery Podiatrist
940-025
WI
213ES0103X
Foot & Ankle Surgery Podiatrist
940-25
WI
Other
Enumeration date
10/13/2008
Last updated
04/21/2026
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