Jessen, Mark D.

Jessen, Mark D. is an individual health care provider with primary practice located at 1326 Andrea St , Bowling Green KY 42104-3334. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Jessen, Mark D. can be contacted via phone (270) 781-1588.

Contact Information

Primary practice address
1326 Andrea St Bowling Green KY 42104-3334
Phone: (270) 781-1588
Fax: (270) 781-1598
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 29379 Kentucky

Profile Details

NPI number 1033174982
LBN Legal business name Jessen, Mark D.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Jul 18th, 2014 - about 12 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 1033174982 NPPES
Kentucky MEDICAID 64293798

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