Healthcare Provider Details

I. General information

NPI: 1649276809
Provider Name (Legal Business Name): JEFFREY JACOB ESPER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E 2ND ST THIRD FLOOR
ERIE PA
16507-1578
US

IV. Provider business mailing address

120 E 2ND ST THIRD FLOOR
ERIE PA
16507-1578
US

V. Phone/Fax

Practice location:
  • Phone: 814-877-8000
  • Fax: 814-452-2210
Mailing address:
  • Phone: 814-877-8000
  • Fax: 814-452-2210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberOS006528L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: