Individual
DR. PAUL JESIONEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6847 N CHESTNUT ST, RAVENNA, OH 44266-3929
(330) 297-2303
Mailing address
66 PRESCOTT DR, HUDSON, OH 44236-2124
(330) 655-0821
(330) 342-5801
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
35061243
OH
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
35-061243
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000213023
ANTHEM PROVIDER NUMBER
OH
05
—
0950823
—
OH
Enumeration date
08/10/2006
Last updated
12/10/2009
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