Anthony, Jesse James

Anthony, Jesse James is an individual health care provider with primary practice located at 1St Mar Rdr Bn Mrr Marforsoc Bldg 132, Camp Lejeune NC 28542. He recently has only one registered license in Other Service Providers / Independent Duty Corpsman, which is considered as his primary health care specialty. Anthony, Jesse James can be contacted via phone (910) 440-2497.

Contact Information

Primary practice address
1St Mar Rdr Bn Mrr Marforsoc Bldg 132 Camp Lejeune NC 28542
Phone: (910) 440-2497
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Independent Duty Corpsman 1710I1002X

Profile Details

NPI number 1205501384
LBN Legal business name Anthony, Jesse James
Credentials SOIDC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2021
Last updated Aug 11th, 2021 - about 3 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 1205501384 NPPES
Other 03179878JA SOCOM-ATP

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