Individual
DR. JOSEPH A JESTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
105 S WILLOW AVE, SUITE 200, COOKEVILLE, TN 38501-3138
(931) 372-7716
(931) 525-1066
Mailing address
105 S WILLOW AVE, COOKEVILLE, TN 38501-4667
(931) 372-7716
(931) 526-9518
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
29172
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3720925
—
TN
05
—
Q013109
—
TN
Enumeration date
01/10/2006
Last updated
10/10/2022
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