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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JACKSON SITTENAUER, MD

Active

DR. JACKSON SITTENAUER, MD is a Military Health Care Provider healthcare provider located in PROVIDENCE, Rhode Island. NPI 1831688084 is currently active in the NPPES registry. Verify at CMS.

Military Health Care Provider · PROVIDENCE, RI

Registration Details

NPI Number
1831688084
Provider Type
Individual
Gender
Male
NPI Issued
May 3, 2018 (8.2572461708998 yrs)
Last Updated
Mar 23, 2024
Licenses
0101267940 (VA)
A193407 (CA)
35.150161 (OH)
E-17506 (AR)

Practice Information

Address
593 EDDY ST
PROVIDENCE, RI, 029034923
Browse RI providers · Browse ZIP 02903
Phone
7852210744
Primary Specialty
Military Health Care Provider
171000000X
Additional Specialty
General Practice
Additional Specialty
General Practice
Additional Specialty
General Practice
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.