Healthcare Provider Details

I. General information

NPI: 1679894224
Provider Name (Legal Business Name): JESSICA DUNCAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA CORTAZZO MD

II. Dates (important events)

Enumeration Date: 06/17/2010
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 REGENT ST STE 200
COLUMBUS OH
43219-6229
US

IV. Provider business mailing address

4200 REGENT ST STE 200
COLUMBUS OH
43219-6229
US

V. Phone/Fax

Practice location:
  • Phone: 877-870-1775
  • Fax: 614-968-8840
Mailing address:
  • Phone: 877-870-1775
  • Fax: 614-968-8840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME125728
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA09248700
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number83316
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number83316
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: