Provider Demographics
NPI:1215955414
Name:JOZLIN, STEPHAN A (PA-C)
Entity type:Individual
Prefix:MR
First Name:STEPHAN
Middle Name:A
Last Name:JOZLIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:217 S. GRAND AVE. THIRD FLOOR
Mailing Address - Street 2:MHM CORRECTIONAL SERVICES, INC.
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48933
Mailing Address - Country:US
Mailing Address - Phone:888-708-3123
Mailing Address - Fax:517-708-3450
Practice Address - Street 1:154 EDGEBROOK DR
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4710
Practice Address - Country:US
Practice Address - Phone:269-579-4223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601002413363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant