Individual
ANN R JESICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15 S 8TH ST, INDIANA, PA 15701-2776
(724) 349-7388
(724) 463-7072
Mailing address
15 S 8TH ST, INDIANA, PA 15701-2776
(724) 349-7388
(724) 463-7072
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD036779
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1132167
—
PA
01
—
162082
BS
—
01
—
7853184
AETNA
—
Enumeration date
08/29/2005
Last updated
01/13/2010
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