Provider Demographics
NPI:1952319014
Name:ZEIGLER, JESSE LITTLETON III (PHARMACIST BS)
Entity Type:Individual
Prefix:MR
First Name:JESSE
Middle Name:LITTLETON
Last Name:ZEIGLER
Suffix:III
Gender:M
Credentials:PHARMACIST BS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2724 WARREN DR.
Mailing Address - Street 2:P O BOX 799
Mailing Address - City:SAINT PAUL
Mailing Address - State:VA
Mailing Address - Zip Code:24283-0799
Mailing Address - Country:US
Mailing Address - Phone:276-762-9385
Mailing Address - Fax:
Practice Address - Street 1:501 FRONT ST W
Practice Address - Street 2:MARTY SHOPPING CENTER
Practice Address - City:COEBURN
Practice Address - State:VA
Practice Address - Zip Code:24230-3607
Practice Address - Country:US
Practice Address - Phone:276-395-2257
Practice Address - Fax:276-395-3526
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2008-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0202005543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA8513457Medicaid
VA8513457Medicaid