Organization
DR. TIM JESSEE, OPTOMETRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY GARLAND JESSEE O.D. (OWNER)
(540) 375-3937
Entity
Organization
Contact information
Practice address
1851 W MAIN ST, SALEM, VA 24153-3111
(540) 375-3937
(540) 387-4219
Mailing address
1851 W MAIN ST, SALEM, VA 24153-3111
(540) 375-3937
(540) 387-4219
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000391
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010237581
—
VA
01
—
186600
ANTHEM BCBS
VA
Enumeration date
06/19/2007
Last updated
11/28/2012
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