DR. Jason D Provus, MD

NPI #1972821320 in Jackson, Wyoming

Provider Information

NPI Number: 1972821320
Entity Type: Individual
Name: DR. Jason D Provus, MD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Orthopaedic Surgery
Credential: MD
Enumeration Date: May 10, 2010
Last Updated: Mar 9, 2024

Practice Location

Address: 555 E BROADWAY AVE STE 129
City: Jackson
State: Wyoming
ZIP Code: 83001-8640
Phone: (307) 733-3900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthopaedic Surgery	207X00000X	Primary

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