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General NPI Number Information
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NPI Number | 1194714469
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Entity Type | Individual
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Provider Name | JOSEPH J JARES III MD
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Gender | Male
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 318 PARK DR
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City | NEENAH
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State | WI
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Zip | 54956-2899
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Country | US
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Telephone | 360-539-8487
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Fax | 360-358-9944
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Provider Business Mailing Address
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Address Line | PO BOX 760
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City | FOX ISLAND
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State | WA
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Zip | 98333-0760
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Country | US
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Telephone | 360-539-8487
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Fax | 603-589-9443
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD60578578
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number | MD60578578
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number | 42460
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 42460
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License Number State | WI
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