Provider Demographics
NPI:1437480647
Name:HANDEL, JESSICA LEIGH (DO)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LEIGH
Last Name:HANDEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1053 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504-1007
Mailing Address - Country:US
Mailing Address - Phone:330-480-3605
Mailing Address - Fax:330-480-2948
Practice Address - Street 1:1053 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1007
Practice Address - Country:US
Practice Address - Phone:330-480-3605
Practice Address - Fax:330-480-2948
Is Sole Proprietor?:No
Enumeration Date:2010-01-28
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.009732207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3053109Medicaid
OHH149660Medicare PIN