Priddy, Jerry

Priddy, Jerry is an individual health care provider with primary practice located at 619 E Mason St Ste 5 , Springfield IL 62701-1080. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Priddy, Jerry can be contacted via phone (217) 545-8000.

Contact Information

Primary practice address
619 E Mason St Ste 5 Springfield IL 62701-1080
Phone: (217) 545-8000
Fax: (217) 545-2552
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 085006117 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085006117 Illinois

Profile Details

NPI number 1003351115
LBN Legal business name Priddy, Jerry
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2016
Last updated Dec 18th, 2024 - about 2 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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