Healthcare Provider Details

I. General information

NPI: 1982597779
Provider Name (Legal Business Name): JACOB WESSLING DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 E COLLEGE ST
HOMER LA
71040-3202
US

IV. Provider business mailing address

515 FORT AVE
MINDEN LA
71055-2519
US

V. Phone/Fax

Practice location:
  • Phone: 318-927-2024
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: