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General NPI Number Information
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NPI Number | 1215986914
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Entity Type | Individual
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Provider Name | JEFFREY DANNER CONANT PA-C
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Gender | Male
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 11/29/2007
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Provider Practice Location Address
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Address Line | 2298 SPRINGPORT RD
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City | JACKSON
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State | MI
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Zip | 49202-1475
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Country | US
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Telephone | 517-784-3950
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Fax | 571-783-2728
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Provider Business Mailing Address
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Address Line | 5880 MCCRUM RD
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City | JACKSON
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State | MI
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Zip | 49201
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Country | US
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Telephone | 517-879-9577
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0509 P
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601005057
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License Number State | MI
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