Individual
DR. JESSICA WEBSTER MACRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
73 WATERBURY ROAD, SUITE 1, CT 06109-4337
(203) 527-9444
(203) 527-9332
Mailing address
1290 SILAS DEANE HWY FL 1, WETHERSFIELD, CT 06109-4337
(860) 972-6970
(860) 972-7040
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
134164
NC
207Q00000X
Family Medicine Physician
Primary
64340
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64340
CT LIC
CT
Enumeration date
07/31/2007
Last updated
09/03/2020
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