Individual
JESSE WAYNE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1601 OWEN DR, FAYETTEVILLE, NC 28304-3425
(910) 678-0100
Mailing address
1601 OWEN DR, FAYETTEVILLE, NC 28304-3425
(517) 975-6000
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/02/2024
Last updated
08/08/2025
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