Jessica Provo, MD
Family Medicine in Sandwich, Massachusetts
1699121368- Practice location
- 90 Route 6A Unit 5A, Sandwich, MA 02563-5301
- Phone
- 508-477-7090
- Fax
- —
- Last updated
- April 22, 2025
Jessica Provo is a Family Medicine based in Sandwich, MA. Jessica Provo practices in Sandwich, MA and has the professional credentials of MD. The NPI Number for Jessica Provo is 1699121368 and holds a License No. 2019-00724 (NC). The current practice location address for Jessica Provo is 90 Route 6A Unit 5A, Sandwich, MA 02563-5301 and can be reached out via phone at 508-477-7090.
Provider Profile Details
- NPI Number
- 1699121368
- Provider Name
- Jessica Provo
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 90 Route 6A Unit 5A, Sandwich, MA 02563-5301
- Phone Number
- 508-477-7090
- Primary Taxonomy
- Family Medicine · 207Q00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- May 11, 2016
- Last Update Date
- April 22, 2025
- Certification Date
- April 7, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 90 Route 6A Unit 5A
Sandwich, MA 02563-5301 - City
- Sandwich
- State
- Massachusetts
- Zip
- 02563-5301
- Phone Number
- 508-477-7090
Provider Business Mailing Address Details
- Address
- Po Box 19305
Charlotte, NC 28219-9305 - City
- Charlotte
- State
- NC
- Zip
- 28219-9305
License Information
- License Number
- 2019-00724
- License State
- NC
- Taxonomy
- Family Medicine · 207Q00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Jessica Provo, MD?
The NPI number of Jessica Provo, MD is 1699121368. It was assigned on May 11, 2016 and is currently active in the NPPES registry.
What is the specialty of Jessica Provo, MD?
Jessica Provo, MD is registered under the primary taxonomy Family Medicine (code 207Q00000X), licensed in NC under license number 2019-00724.
Where does Jessica Provo, MD practice?
The practice location is 90 Route 6A Unit 5A, Sandwich, MA 02563-5301. The office can be reached at 508-477-7090 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1699121368 directly on the NPPES registry website.