Provider Demographics
NPI:1679779276
Name:PACE, JESSE LEE (DO)
Entity type:Individual
Prefix:DR
First Name:JESSE
Middle Name:LEE
Last Name:PACE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:353 BOGLE ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2888
Mailing Address - Country:US
Mailing Address - Phone:606-678-2220
Mailing Address - Fax:606-678-2219
Practice Address - Street 1:161 E UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36832-5889
Practice Address - Country:US
Practice Address - Phone:334-826-2090
Practice Address - Fax:334-821-3191
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2014-08-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH34.008380207X00000X
ALDO.1014207XX0005X
FLOS12882207X00000X
KY03290207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery