Individual provider · Type 1 NPI

Jason Thomas William Tetzlaff, IDC

Independent Duty Corpsman · San Diego, CA

NPI number 1043247091 Active

Practice location

3402 Tarawa Rd, SBT-12
San Diego, CA 92155-5176

Call (619) 437-5539 Map

Fax (619) 437-2955

Mailing address

4742 Gainard Way
San Diego, CA 92124-2913

Specialties and licenses

Taxonomy	Code	License
Independent Duty Corpsman Primary	1710I1002X	2099 (AZ)
Specialist	174400000X	None listed
Military Health Care Provider	171000000X	2099 (CA)

Independent Duty Corpsman: A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and othe…

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About NPI 1043247091

Jason Thomas William Tetzlaff, IDC's National Provider Identifier is 1043247091, issued on Jun 26, 2006. The primary taxonomy on file is Independent Duty Corpsman (1710I1002X), and the practice location is in San Diego, CA. The record was last updated on Apr 22, 2008.