Carroll, William Jessup

Carroll, William Jessup is an individual health care provider with primary practice located at 2705 Jefferson Rd , Athens GA 30607-1208. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Carroll, William Jessup can be contacted via phone (706) 543-3200.

Contact Information

Primary practice address
2705 Jefferson Rd Athens GA 30607-1208
Phone: (706) 543-3200
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036.142862 Illinois
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X ME140137 Florida
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 91276 Georgia

Profile Details

NPI number 1891130829
LBN Legal business name Carroll, William Jessup
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2013
Last updated Mar 28th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891130829 NPPES
Georgia MEDICAID 003265416A
Georgia MEDICAID 003265416B
Georgia MEDICAID 102600100
Georgia MEDICAID 003265416C

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