| Doctor Name: | DR. APOLINAR ED A JOVELLANA |
| NPI Number: | 1023026903 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 25311020 |
| Business Practice Address: | 5409 Everybodys Road Forest County Potawatomi Health & Wellness Center Crandon, WI - 54520 |
| Business Phone Number: | 7154784300 |
| Business Fax Number: | 7154784490 |
| Mailing Address: | 3144 Vanlile Road, CRANDON |
| State: | WI |
| Postal Code: | 545208149 |
| Phone Number: | 7154785180 |
| Fax Number: | 7154785904 |
| NPI Enumeration Date: | 08/04/2006 |
| NPI Last Update Date: | 05/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 25311020 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |