Individual
JEFFREY J EVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
260 26TH ST, PRAIRIE DU SAC, WI 53578-2203
(608) 643-2471
(608) 643-4788
Mailing address
260 26TH ST, PRAIRIE DU SAC, WI 53578-2203
(608) 643-2471
(608) 643-4788
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1048
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42977700
—
WI
Enumeration date
04/18/2006
Last updated
03/24/2021
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