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General NPI Number Information
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NPI Number | 1558427849
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Entity Type | Organization
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Legal Business Name | JEFFERSON COUNTY PUBLIC HEALTH SERVICE
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 531 MEADE ST
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City | WATERTOWN
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State | NY
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Zip | 13601-1225
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Country | US
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Telephone | 315-786-3710
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Fax | 315-786-3761
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Provider Business Mailing Address
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Address Line | 531 MEADE ST
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City | WATERTOWN
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State | NY
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Zip | 13601-1225
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Country | US
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Telephone | 315-786-3710
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Fax | 315-786-3761
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Authorized Official
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Title or Position | PUBLIC HEALTH DIRECTOR
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Name | MR. STEPHEN A. JENNINGS
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Credential |
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Telephone | 315-786-3715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number | 2201200R
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License Number State | NY
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