MEDICARE: JESSE LEE SANDLIN M.D.

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
1	207X00000X	Orthopaedic Surgery Physician	01061153A	IN
2	207X00000X	Orthopaedic Surgery Physician	0101244584	VA
3	207X00000X	Orthopaedic Surgery Physician	46817	TN
4	207X00000X	Orthopaedic Surgery Physician	MD460512	PA

General Provider Information

NPI Number	:	1942279807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSE LEE SANDLIN M.D.

Provider Business Mailing Address
First Line	:	3421 CONCORD RD
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-9001
Country	:	US
Telephone Number	:	717-339-2500
Fax Number	:	717-339-2502

Provider Business Practice Location Address
First Line	:	18 DEATRICK DR
Second Line	:
City	:	GETTYSBURG
State	:	PA
Zip	:	17325-6958
Country	:	US
Telephone Number	:	717-339-2500
Fax Number	:	717-339-2502

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	04/07/2017

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