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Individual

GREGORY A JARVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAAA

Contact information

Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-8700
(414) 259-1522
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-8700
(414) 259-1522

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
006538
GA
367H00000X
Anesthesiologist Assistant
Primary
106
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1972854644
WI
Enumeration date
09/21/2012
Last updated
12/27/2017
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