Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 4014 | RI |
N | 2080P0204X | Pediatric Emergency Doctor | 57676 | MA |
NPI | 1114909082 |
---|---|
Provider Name | Dr. Frank Joseph Jehle JR. |
First Address | North Kingston, RI 02852 |
Second Address | North Kingston, RI 02852 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 07/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3089096 | (05) | MA |
C89890 | (02) | MA |