Provider Demographics
NPI:1093947087
Name:MAXWELL, JESSICA HOOTON (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:HOOTON
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 SAVANNAH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15218-1319
Mailing Address - Country:US
Mailing Address - Phone:734-730-4134
Mailing Address - Fax:
Practice Address - Street 1:1128 SAVANNAH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15218-1319
Practice Address - Country:US
Practice Address - Phone:734-730-4134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA30086790207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology