Individual
DR. DAVID LANING JESPERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
10 E MAIN ST STE B, MILLVILLE, NJ 08332-4293
(856) 293-1880
(856) 293-1889
Mailing address
10 E MAIN ST STE B, MILLVILLE, NJ 08332-4293
(856) 293-1880
(856) 293-1889
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00256400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201840202
TAX ID
NJ
01
—
7040196
AETNA PROVIDER #
NJ
05
—
8270902
—
NJ
Enumeration date
05/10/2007
Last updated
02/08/2022
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