Provider Demographics
NPI:1285674150
Name:WESTERMAN, JAN
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:
Last Name:WESTERMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 SUMMITT
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-0102
Mailing Address - Country:US
Mailing Address - Phone:205-387-7555
Mailing Address - Fax:205-384-9006
Practice Address - Street 1:1280 SUMMITT
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-0102
Practice Address - Country:US
Practice Address - Phone:205-387-7555
Practice Address - Fax:205-384-9006
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32298207RC0200X
MDD82312207RP1001X
AL13090207RP1001X
MT390200000X
AL00013090207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000034844Medicaid
ALC87097Medicare UPIN
AL000034844Medicare PIN
AL510I290005Medicare PIN