Mctavish, Jeffrey Donald

Mctavish, Jeffrey Donald is an individual health care provider with primary practice located at 110 Kingsley Ln , Norfolk VA 23505-4617. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Mctavish, Jeffrey Donald can be contacted via phone (804) 262-6900.

Contact Information

Primary practice address
110 Kingsley Ln Norfolk VA 23505-4617
Phone: (804) 262-6900
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 0101231812 Virginia

Profile Details

NPI number 1407817414
LBN Legal business name Mctavish, Jeffrey Donald
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2006
Last updated Jun 18th, 2019 - about 5 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 1407817414 NPPES
Virginia MEDICAID 7243243

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