Provider Demographics
NPI:1275581795
Name:EGGERS, JASON LAVERN (MD, DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:LAVERN
Last Name:EGGERS
Suffix:
Gender:M
Credentials:MD, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 VIKINGS CIR
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-1002
Mailing Address - Country:US
Mailing Address - Phone:952-456-7600
Mailing Address - Fax:952-456-7601
Practice Address - Street 1:2700 VIKINGS CIR
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55121-1002
Practice Address - Country:US
Practice Address - Phone:952-456-7600
Practice Address - Fax:952-456-7601
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2922111NS0005X
MN54681208100000X
PAMT205482208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician