Organization
HEALTHSURE MEDICAL CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PEACE N JESSA DO (OWNER)
(859) 223-0006
Entity
Organization
Contact information
Practice address
2406 GREATSTONE PT, LEXINGTON, KY 40504-3274
(859) 223-0006
(859) 224-0005
Mailing address
2406 GREATSTONE POINT, LEXINGTON, KY 40504-3274
(859) 223-0006
(859) 224-0005
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
02871
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000736990
ANTHEM
KY
05
—
7100185990
—
KY
Enumeration date
06/27/2011
Last updated
01/30/2012
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