Provider Demographics
NPI:1962639062
Name:SAMMON, JESSE D (DO)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:D
Last Name:SAMMON
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:301C US ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-9701
Mailing Address - Country:US
Mailing Address - Phone:207-396-8600
Mailing Address - Fax:207-396-8632
Practice Address - Street 1:100 BRICKHILL AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-1999
Practice Address - Country:US
Practice Address - Phone:207-773-1728
Practice Address - Fax:207-773-8153
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2016-06-06
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Provider Licenses
StateLicense IDTaxonomies
MEDO2589208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology