Clement, Jac A

Clement, Jac A is an individual health care provider with primary practice located at 820 Arbutus Ave , Oconto WI 54153-2004. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Clement, Jac A can be contacted via phone (920) 835-1100.

Contact Information

Primary practice address
820 Arbutus Ave Oconto WI 54153-2004
Phone: (920) 835-1100
Fax: (920) 835-1099
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 603-023 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085-001577 Illinois

Profile Details

NPI number 1649289778
LBN Legal business name Clement, Jac A
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 7th, 2006
Last updated Nov 18th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649289778 NPPES
Wisconsin MEDICAID 42940500

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