Individual
DR. JESSICA RUTH THIESSEN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 TIPPETT CT, SUITE 101, SUNBURY, OH 43074-8572
(740) 965-3123
(740) 965-9713
Mailing address
L-3401, COLUMBUS, OH 43260-3401
(740) 615-1324
(740) 615-1344
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.095047
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3144869
—
OH
Enumeration date
02/19/2009
Last updated
01/05/2022
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