Provider Demographics
NPI:1710429303
Name:CLAIRMONT, JACOB JOEL (PA)
Entity Type:Individual
Prefix:MR
First Name:JACOB
Middle Name:JOEL
Last Name:CLAIRMONT
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 WABASHA ST S
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55107-1805
Practice Address - Country:US
Practice Address - Phone:952-853-8800
Practice Address - Fax:651-293-8106
Is Sole Proprietor?:No
Enumeration Date:2016-11-14
Last Update Date:2022-08-31
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Provider Licenses
StateLicense IDTaxonomies
MN12218363A00000X
NC0010-12145363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant