Provider Demographics
NPI:1013271378
Name:MOHR, JEFFREY JOHN (PA-C)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:JOHN
Last Name:MOHR
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3229 OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-2003
Mailing Address - Country:US
Mailing Address - Phone:612-210-1983
Mailing Address - Fax:
Practice Address - Street 1:1885 PLAZA DR
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-2979
Practice Address - Country:US
Practice Address - Phone:952-993-4001
Practice Address - Fax:952-993-4095
Is Sole Proprietor?:No
Enumeration Date:2012-07-01
Last Update Date:2012-07-01
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical