Organization
JESSIE CLAIRVIL, DO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSIE CLAIRVIL D.O (OTOLARYNGOLOGIST)
(856) 339-0800
Entity
Organization
Contact information
Practice address
545 BECKETT RD, SUITE 206, SWEDESBORO, NJ 08085-1547
(856) 339-0800
(856) 339-0884
Mailing address
545 BECKETT RD, SUITE 206, SWEDESBORO, NJ 08085-1547
(856) 339-0800
(856) 339-0884
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
25MB07620000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0210471
—
NJ
Enumeration date
08/05/2007
Last updated
03/12/2014
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