Fogarty, Jacqueline Mary
Fogarty, Jacqueline Mary is an sole proprietor health care provider with primary practice located at 409 Oak Ln , South Boston VA 24592-1633. She recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as her primary health care specialty. Fogarty, Jacqueline Mary can be contacted via phone (434) 572-8300.Contact Information
Primary practice address
409 Oak Ln
South Boston VA 24592-1633
Phone: (434) 572-8300
Fax: (434) 572-1659
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 0101035912 | Virginia |
Profile Details
| NPI number | 1821051525 |
|---|---|
| LBN Legal business name | Fogarty, Jacqueline Mary |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 11th, 2006 |
| Last updated | Nov 18th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821051525 | NPPES |
| Virginia | MEDICAID | 6401767 | |
| Virginia | Other | 078069 | |
| Virginia | Other | 200019809 |
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