Individual
DR. ELISE A JACQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
123 SUMMER ST, SUITE 650, WORCESTER, MA 01608-1216
(508) 363-9570
(508) 363-9590
Mailing address
123 SUMMER ST, SUITE 650, WORCESTER, MA 01608-1216
(508) 363-9570
(508) 363-9590
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
37631
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2062925
—
MA
Enumeration date
10/11/2005
Last updated
01/13/2011
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