Individual
DOUGLAS E JESSUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7858 SHRADER RD, RICHMOND, VA 23294
(804) 270-1305
(804) 273-9294
Mailing address
1115 BOULDERS PKWY, SUITE 200, NORTH CHESTERFIELD, VA 23225-4067
(804) 560-5595
(804) 560-9029
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101036486
VA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
0101036486
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6496059
—
VA
Enumeration date
02/27/2006
Last updated
12/01/2017
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