Basic Information
| Provider Information | |||||||||
| NPI: | 1417924184 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TESSMANN | ||||||||
| FirstName: | DON | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24 CLAY STREET | ||||||||
| Address2: | |||||||||
| City: | MARTINSVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 24112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2766327128 | ||||||||
| FaxNumber: | 2766320127 | ||||||||
| Practice Location | |||||||||
| Address1: | 24 CLAY STREET | ||||||||
| Address2: | |||||||||
| City: | MARTINSVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 24112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2766327128 | ||||||||
| FaxNumber: | 2766320127 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2006 | ||||||||
| LastUpdateDate: | 06/22/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 0101043297 | VA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | O87530 | 01 | VA | SENTARA BEHAVIORAL HEALTH | OTHER | 004945085 | 05 | VA | MEDICAID | 004945221 | 05 | VA | MEDICAID | 240195 | 01 | VA | ANTHEM | OTHER |