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Search › Wyoming › 207X00000X

Jason Provus, MD

NPI 1972821320 · on the registry since 2010 · sole proprietor

Practice

Address
555 E Broadway Ave Ste 129
Jackson, WY 83001
Phone
(307) 733-3900
Fax
(307) 739-7683
Organisation at this address
Hole Ortho Llc
Karin L Klee Md
Teton Pediatrics Pc
Mountain Therapy Pllc
Family First Health Pc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
66

Registry record

Primary taxonomy
207X00000X
207X00000X
Licence states on file
WY
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-03-09

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wyoming