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General NPI Number Information
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NPI Number | 1518916501
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Entity Type | Individual
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Provider Name | SHAUN PATRICK JESTER DO
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Gender | Male
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2241 ROMBACH AVE
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City | WILMINGTON
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State | OH
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Zip | 45177-1995
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Country | US
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Telephone | 937-283-2588
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Fax |
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Provider Business Mailing Address
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Address Line | 3420 22ND PL
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City | LUBBOCK
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State | TX
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Zip | 79410-1314
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Country | US
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Telephone | 806-725-5844
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Fax | 806-723-6532
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | OS012463
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 34.008226
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | M3275
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License Number State | TX
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