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General NPI Number Information
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NPI Number | 1902028244
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Entity Type | Organization
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Legal Business Name | RICHARD D. JELSMA, MD, PA
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 425 N HIGHLAND AVE SUITE 110
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City | SHERMAN
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State | TX
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Zip | 75092-7377
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Country | US
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Telephone | 903-868-8800
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Fax | 903-868-4405
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Provider Business Mailing Address
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Address Line | 425 N HIGHLAND AVE SUITE 110
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City | SHERMAN
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State | TX
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Zip | 75092-7377
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Country | US
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Telephone | 903-868-8800
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Fax | 903-868-4405
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Authorized Official
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Title or Position | ORTHOPEDIC SURGEON
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Name | RICHARD JELSMA
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Credential | MD
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Telephone | 903-868-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | J8284
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License Number State | TX
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