Individual
JEFFREY CARR JESSUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
7091 OLD HARDING PIKE, SUITE 105, NASHVILLE, TN 37221
(615) 662-2800
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
859
TN
152WC0802X
Corneal and Contact Management Optometrist
ODT859
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0047504
—
TN
01
—
0792070001
MEDICARE DMERC PIN
TN
Enumeration date
12/28/2006
Last updated
12/21/2021
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