Individual
JESSE WILLIAM WAYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0002
(706) 721-8623
(706) 721-1459
Mailing address
1120 15TH ST # OR6000, AUGUSTA, GA 30912-0004
(706) 721-3813
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
101021
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11976
GEORGIA COMPOSITE MEDICAL BOARD
GA
Enumeration date
06/12/2020
Last updated
08/05/2024
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