REVONDA L JESSUP

JESSUP FOOT AND ANKLE SPECIALISTS, PA

Dr REVONDA L JESSUP is a female medical professional, specializing in Podiatry. She graduated in 2004 from Temple University School Of Medicine.

Contact

JESSUP FOOT AND ANKLE SPECIALISTS, PA

9601 HOLLY POINT DR
SUITE 203
HUNTERSVILLE
NC
280785069

Tel: 7048920949

REVONDA L JESSUP Information

Npi 1235346172
Pac Id 7214021989
Professional Enrollment Id I20070926000222
Last Name JESSUP
First Name REVONDA
Middle Name L
Suffix
Gender F
Credential
Medical School Name TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year 2004
Primary Specialty PODIATRY
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name JESSUP FOOT AND ANKLE SPECIALISTS, PA
Group Practice Pac Id 3274718952
Number Of Group Practice Members 2
Line 1 Street Address 9601 HOLLY POINT DR
Line 2 Street Address SUITE 203
Marker Of Address Line 2 Suppression
City HUNTERSVILLE
State NC
Zip Code 280785069
Phone Number 7048920949
Hospital Affiliation Ccn 1 340032
Hospital Affiliation Lbn 1 GASTON MEMORIAL HOSPITAL, INC.
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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