Individual ProviderJessica WaughtelInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4300 Londonderry Rd, Harrisburg, PA 17109-5317(717) 230-3700PECOS EnrollmentBased on the most recent information from CMS, provider Jessica Waughtel is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 15 days ago.Profile DetailsProvider ID1083960710Provider TypeIndividualFull NameWaughtel, JessicaCredentialD.O.GenderFemaleSole ProprietorNoEnumeration Date7/31/2012Last Updated2/21/2020Contact InformationPractice LocationPractice Address4300 Londonderry Rd, Harrisburg, PA 17109-5317Phone(717) 230-3700FaxUnlisted FaxMailing LocationMailing Address4300 Londonderry Rd, Harrisburg, PA 17109-5317PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseOS017989Pennsylvania