Provider Demographics
NPI:1659687069
Name:KERSHNER, JESSE BRANDON (OD)
Entity type:Individual
Prefix:DR
First Name:JESSE
Middle Name:BRANDON
Last Name:KERSHNER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:
Practice Address - Street 1:3101 SW COLLEGE RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-8459
Practice Address - Country:US
Practice Address - Phone:352-237-3768
Practice Address - Fax:352-237-4595
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-23
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4518152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist