Individual
JERRY MICHAEL JESSEPH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 W 1ST ST, BLOOMINGTON, IN 47403-2205
(812) 332-7277
(812) 332-0405
Mailing address
PO BOX 96, SMITHVILLE, IN 47458-0096
(812) 824-8787
(812) 824-8787
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01030317A
IN
Other
Enumeration date
05/05/2006
Last updated
07/08/2007
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