Individual
PETER L JEBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4100 LAKE DR SE, STE. 300, GRAND RAPIDS, MI 49546-8292
(616) 267-8860
(616) 267-8442
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
4301069004
MI
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
4301069004
MI
Other
Enumeration date
10/05/2006
Last updated
11/13/2014
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