Provider Demographics
NPI:1043551419
Name:LAFYATIS, JESSICA MARTIN (DO)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MARTIN
Last Name:LAFYATIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:945 BETHESDA DR STE 330
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1880
Mailing Address - Country:US
Mailing Address - Phone:419-308-1174
Mailing Address - Fax:
Practice Address - Street 1:945 BETHESDA DR STE 330
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1880
Practice Address - Country:US
Practice Address - Phone:740-454-8800
Practice Address - Fax:740-454-7707
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-11
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34.012607207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty