Individual
DAVID MATTHEW JETTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3401 LUDINGTON ST, ESCANABA, MI 49829-1300
(906) 786-5707
Mailing address
217 N 13TH ST, 1/2 UPPER, ESCANABA, MI 49829-3533
(610) 505-9954
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100055667
—
WI
Enumeration date
07/01/2013
Last updated
09/01/2022
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