Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 6346 | VA |
Y | 213EG0000X | General Practice | 6346 | VA |
NPI | 1003916115 |
---|---|
Provider Name | Dr. David L. Jones |
First Address | Virginia Beach, VA 23456-3907 |
Second Address | Virginia Beach, VA 23456-3907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 08/07/2007 |