Individual
DR. JULIAN JERROD JESUBATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 OFFICE PARK DR, GULF SHORES, AL 36542-3432
(251) 968-7379
(251) 968-5960
Mailing address
200 OFFICE PARK DR, GULF SHORES, AL 36542-3432
(251) 968-7379
(251) 968-5960
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD.36071
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
244212
—
AL
Enumeration date
07/01/2010
Last updated
11/13/2020
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