Iacobucci, Mark John

Iacobucci, Mark John is an individual health care provider with primary practice located at 3235 Academy Ave Suite 200, Portsmouth VA 23703. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Iacobucci, Mark John can be contacted via phone (757) 483-0400.

Contact Information

Primary practice address
3235 Academy Ave Suite 200 Portsmouth VA 23703
Phone: (757) 483-0400
Fax: (757) 548-9563
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 0101056490 Virginia

Profile Details

NPI number 1295715324
LBN Legal business name Iacobucci, Mark John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2006
Last updated Jun 4th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295715324 NPPES
Virginia MEDICAID 1295715324
Virginia Other 294885

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