Most Relevant Information
Provider Data
| NPI Number: | 1003272485 |
| Provider Name: | JASON DEDEKER |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/14/2016 |
| Last Updated: | 01/14/2016 |
Provider Practice Location
620 JOHN PAUL JONES CIR
NAVAL MEDICAL CENTER PORTSMOUTH
PORTSMOUTH
VA
237082197
Practice Location Phone/Fax
| Phone: | 7579535257 |
| Fax: |
Provider Mailing Location
3849 WILHOIT RD
APISON
TN
373029783
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |