Jessie Clairvil, DO LLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

25MB07620000 Issued in NJ

Legal business name

JESSIE CLAIRVIL, DO LLC

Practice address

545 Beckett Rd
Suite 206
Swedesboro, NJ 08085-1547

Phone

(856) 339-0800

Fax

(856) 339-0884

NPI assigned

Aug 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jessie Clairvil, D.O

Title

Otolaryngologist

Phone

(856) 339-0800

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394582400000",
    "number": "1457542532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 BECKETT RD",
            "address_2": "SUITE 206",
            "city": "SWEDESBORO",
            "state": "NJ",
            "postal_code": "080851547",
            "telephone_number": "856-339-0800",
            "fax_number": "856-339-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 BECKETT RD",
            "address_2": "SUITE 206",
            "city": "SWEDESBORO",
            "state": "NJ",
            "postal_code": "080851547",
            "telephone_number": "856-339-0800",
            "fax_number": "856-339-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSIE CLAIRVIL, DO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2014-03-12",
        "status": "A",
        "authorized_official_last_name": "CLAIRVIL",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "OTOLARYNGOLOGIST",
        "authorized_official_telephone_number": "856-339-0800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "NJ",
            "license": "25MB07620000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0210471",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology Physician in Swedesboro, NJ
• Providers in Swedesboro, NJ by specialty
• Otolaryngology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.