JACKSON SITTENAUER

PROVIDENCE, RI
NPI1831688084
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171000000X Military Health Care Provider
(Licence: VA  0101267940)
Additional Taxonomies208D00000X General Practice
(Licence: CA  A193407)
208D00000X General Practice
(Licence: OH  35.150161)
208D00000X General Practice
(Licence: AR  E-17506)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2018-05-03
Last Update Date2024-03-23
Business Address
Dr. JACKSON SITTENAUER MD
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number: 785-221-0744
Mailing Address
Dr. JACKSON SITTENAUER MD
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number: 785-221-0744
Similar providers in Providence, RI