Jessup, Neal S

Jessup, Neal S is an individual health care provider with primary practice located at 2205 Orange Ave Ne , Roanoke VA 24012-8305. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Jessup, Neal S can be contacted via phone (540) 343-2197.

Contact Information

Primary practice address
2205 Orange Ave Ne Roanoke VA 24012-8305
Fax: (540) 343-3575
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 0601001553 Virginia

Profile Details

NPI number 1972504645
LBN Legal business name Jessup, Neal S
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2005
Last updated Jun 20th, 2018 - about 8 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 1972504645 NPPES
Virginia MEDICAID 010220131

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