Jerry Priddy, PA-C

NPI #1003351115 in Springfield, Illinois

Provider Information

NPI Number: 1003351115
Entity Type: Individual
Name: Jerry Priddy, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Dec 28, 2016
Last Updated: Dec 18, 2024

Practice Location

Address: 619 E MASON ST STE 5
City: Springfield
State: Illinois
ZIP Code: 62701-1080
Phone: (217) 545-8000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant - Surgical — Surgical	363AS0400X
Physician Assistant	363A00000X	Primary

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