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General NPI Number Information
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NPI Number | 1114210325
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Entity Type | Individual
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Provider Name | JESSICA STEPP DO
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Gender | Female
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Dates
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Enumeration Date | 05/20/2011
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 602 W MEMORIAL DRIVE
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City | DALLAS
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State | GA
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Zip | 30132
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Country | US
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Telephone | 943-202-7870
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Fax | 470-986-7205
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Provider Business Mailing Address
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Address Line | 602 W MEMORIAL DR SUITE 101
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City | DALLAS
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State | GA
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Zip | 30132
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Country | US
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Telephone | 943-202-7870
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Fax | 470-986-7205
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 069261
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License Number State | GA
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