Provider Demographics
NPI:1861672669
Name:GESSEL, JASON LEE (DO)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:LEE
Last Name:GESSEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-2123
Mailing Address - Country:US
Mailing Address - Phone:740-373-8756
Mailing Address - Fax:
Practice Address - Street 1:611 2ND ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-2123
Practice Address - Country:US
Practice Address - Phone:740-373-8756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2631207X00000X
OH34.009595207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810023359Medicaid
OHH092690Medicare PIN
WV3810023359Medicaid