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General NPI Number Information
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NPI Number | 1275581795
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Entity Type | Individual
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Provider Name | JASON LAVERN EGGERS MD, DC
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Gender | Male
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 08/16/2024
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Provider Practice Location Address
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Address Line | 2700 VIKINGS CIR
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City | EAGAN
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State | MN
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Zip | 55121-1002
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Country | US
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Telephone | 952-456-7600
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Fax | 952-456-7601
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Provider Business Mailing Address
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Address Line | 2700 VIKINGS CIR
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City | EAGAN
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State | MN
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Zip | 55121-1002
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Country | US
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Telephone | 952-456-7600
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Fax | 952-456-7601
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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 | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 2922
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 54681
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 54681
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License Number State | MN
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