Healthcare Provider Details

I. General information

NPI: 1295047819
Provider Name (Legal Business Name): CAROL ELIZABETH JESSEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2010
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15267 E LIMESTONE RD
HARVEST AL
35749-7223
US

IV. Provider business mailing address

15267 E LIMESTONE RD
HARVEST AL
35749-7223
US

V. Phone/Fax

Practice location:
  • Phone: 254-247-8291
  • Fax: 256-790-7977
Mailing address:
  • Phone: 254-247-8291
  • Fax: 256-290-7977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD52118
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: