Provider Demographics
NPI:1972989721
Name:GESULGA, JAYSON (PA)
Entity Type:Individual
Prefix:
First Name:JAYSON
Middle Name:
Last Name:GESULGA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2900 WESTOWN PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1315
Mailing Address - Country:US
Mailing Address - Phone:515-227-6065
Mailing Address - Fax:833-907-2405
Practice Address - Street 1:2900 WESTOWN PKWY STE 130
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1315
Practice Address - Country:US
Practice Address - Phone:515-227-6065
Practice Address - Fax:833-907-2405
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
363A00000X
IA081477363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant