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Contact Information

JASON G DE VRIES, DPM
1111 BAYSHORE DR
MANITOWOC, WI54220-5548
 Phone: 920-682-6376
 Fax: 920-652-0115
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JASON G DE VRIES · (Male)

NPI Number 1609028422
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 10/13/2008
Last updated 04/21/2026 - About 1 months ago
Sole proprietor 1 No
Identifiers
  • WI License # 940
  • WI License # 940-025
  • WI License # 940-25
Hospital affiliation(s)
  • AURORA BAYCARE MED CTR - (Acute Care)
    2845 GREENBRIER RD
    GREEN BAY, WI 54311
  • AURORA MED CTR MANITOWOC CTY - (Acute Care)
    5000 MEMORIAL DRIVE
    TWO RIVERS, WI 54241
  • HOLY FAMILY MEMORIAL INC - (Acute Care)
    2300 WESTERN AVE
    MANITOWOC, WI 54221
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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