MEDICARE: DARREL JESSOP, M.D., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1801972443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DARREL JESSOP, M.D., P.C.

Provider Business Mailing Address
First Line	:	6261 N LA CHOLLA BLVD
Second Line	:	SUITE 211
City	:	TUCSON
State	:	AZ
Zip	:	85741-3565
Country	:	US
Telephone Number	:	520-575-5061
Fax Number	:	520-878-9010

Provider Business Practice Location Address
First Line	:	6261 N LA CHOLLA BLVD
Second Line	:	SUITE 211
City	:	TUCSON
State	:	AZ
Zip	:	85741-3565
Country	:	US
Telephone Number	:	520-575-5061
Fax Number	:	520-878-9010

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	DR. DARREL JESSOP
Credential	:	MD
Telephone Number	:	520-575-5061

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	08/22/2020

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