Provider Demographics
NPI:1083062863
Name:JOUBERT, JYOVANI (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JYOVANI
Middle Name:
Last Name:JOUBERT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-0366
Mailing Address - Country:US
Mailing Address - Phone:413-733-0010
Mailing Address - Fax:413-930-2108
Practice Address - Street 1:134 CAPITAL DR STE E
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-1320
Practice Address - Country:US
Practice Address - Phone:413-733-0010
Practice Address - Fax:413-417-2978
Is Sole Proprietor?:No
Enumeration Date:2016-06-02
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant