Provider Demographics
NPI:1790707800
Name:FRISSELL, JEREMY (PA)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:FRISSELL
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Gender:M
Credentials:PA
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Mailing Address - Street 1:RHODE ISLAND SURGEONS INC
Mailing Address - Street 2:1539 ATWOOD AVENUE SUITE 201
Mailing Address - City:JOHNSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02919
Mailing Address - Country:US
Mailing Address - Phone:401-521-6310
Mailing Address - Fax:401-861-9596
Practice Address - Street 1:RHODE ISLAND SURGEONS INC
Practice Address - Street 2:1539 ATWOOD AVENUE SUITE 201
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919
Practice Address - Country:US
Practice Address - Phone:401-521-6310
Practice Address - Fax:401-861-9596
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2008-05-05
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical