Provider Demographics
NPI:1568199750
Name:ESCHETE, JAI WAYNE (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:JAI
Middle Name:WAYNE
Last Name:ESCHETE
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HIGH FOREST LN
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-7800
Mailing Address - Country:US
Mailing Address - Phone:662-322-3077
Mailing Address - Fax:
Practice Address - Street 1:108 HIGH FOREST LN
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-7800
Practice Address - Country:US
Practice Address - Phone:662-322-3077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-07
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT1452225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist