National Provider Identifier

Jerry Varghese Thuthikattu John, MD

Jerry Varghese Thuthikattu John, MD is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Jamestown, NY and a listed phone number of (716) 483-6700.

NPI 1053920504Jamestown, NYFamily Medicine Physician

Profile Overview

NPI
1053920504
Provider Type
Individual
Primary Specialty
Family Medicine Physician
Enumeration Date
July 29, 2020
Last Updated
August 03, 2023

Practice Location

  • 15 S Main St Ste 150
  • Jamestown, NY 14701-6627

Phone: (716) 483-6700

Mailing Address

  • 2400 W Villard Ave
  • Milwaukee, WI 53209-4901

Specialties

  • Family Medicine Physician (207Q00000X)
  • Family Medicine Physician (207Q00000X)
Full Record
NPI
1053920504
Entity Type
Individual
Last Name
John
First Name
Jerry
Middle Name
Varghese Thuthikattu
Name Prefix
Dr.
Credential
MD
Mailing Street Address
2400 W Villard Ave
Mailing City
Milwaukee
Mailing State
WI
Mailing ZIP Code
53209-4901
Mailing Country
US
Mailing Phone
(414) 527-8191
Practice Street Address
15 S Main St Ste 150
Practice City
Jamestown
Practice State
NY
Practice ZIP Code
14701-6627
Practice Country
US
Practice Phone
(716) 483-6700
Practice Fax
(716) 664-7275
Enumeration Date
July 29, 2020
Last Updated
August 03, 2023
Sex
Male
Sole Proprietor
No
Certification Date
August 03, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Family Medicine Physician (207Q00000X), Family Medicine Physician (207Q00000X)