Provider Demographics
NPI:1831127182
Name:WESSON, JEFFREY A (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:WESSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 NEWTOWN RD
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3130
Mailing Address - Country:US
Mailing Address - Phone:978-263-8521
Mailing Address - Fax:978-263-7319
Practice Address - Street 1:296 GREAT RD
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-4710
Practice Address - Country:US
Practice Address - Phone:978-263-8521
Practice Address - Fax:978-263-7319
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2356152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0019264OtherNEIGHBORHOOD HEALTH
MA5892591-001OtherCIGNA
MA22-00509OtherUNITED HEALTHCARE
MA64611OtherFALLON
MAW15180OtherHMO BLUE
MA15355OtherHEALTHSOURCE
MA60640OtherAETNA
MA404799OtherTUFTS MEDICARE PREFERRED
MAAMA105OtherFREEDOM HARVARD
MA0323217Medicaid
MA404799OtherTUFTS
MAAMA105OtherHARVARD PILGRIM HEALTH
MAT59165Medicare UPIN
MA64611OtherFALLON