Provider Demographics
NPI:1912292640
Name:JEWETT, FREDERIC CARR III (DO)
Entity Type:Individual
Prefix:DR
First Name:FREDERIC
Middle Name:CARR
Last Name:JEWETT
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NAVAL HOSPITAL OKINAWA
Mailing Address - Street 2:CAMP FOSTER
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96362
Mailing Address - Country:US
Mailing Address - Phone:215-776-6233
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HOSPITAL OKINAWA
Practice Address - Street 2:CAMP FOSTER
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96362
Practice Address - Country:US
Practice Address - Phone:215-776-6233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12441207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology