Individual
MICHAEL J JESSUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1810 E PLAZA WAY, CAPE GIRARDEAU, MO 63703-5842
(573) 335-1344
Mailing address
1810 E PLAZA WAY, CAPE GIRARDEAU, MO 63703-5842
(573) 335-1344
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
100630
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203338736
—
MO
01
—
27801
BCB S
MO
Enumeration date
07/29/2005
Last updated
05/19/2022
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