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NPI Code Detail

MEDICARE: JESSICA JERRARD DO

MEDICARE: JESSICA JERRARD DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianOS006297LPA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1009452H14OTHERDEMEDICARE

General Provider Information

NPI Number : 1376533521
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA JERRARD DO
Provider Business Mailing Address
First Line : 10800 KNIGHTS RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19114-4200
Country : US
Telephone Number : 215-612-4000
Fax Number :
Provider Business Practice Location Address
First Line : 10800 KNIGHTS RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19114-4200
Country : US
Telephone Number : 215-612-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2005
Last Update Date : 10/20/2011

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Directions to “ JESSICA JERRARD DO” Practice Location

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