1861900110 NPI number — JULES A. FELEDY, JR., MD., PLLC

Table of content: (NPI 1861900110)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861900110 NPI number — JULES A. FELEDY, JR., MD., PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JULES A. FELEDY, JR., MD., PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861900110
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2071 JEFFERSON DAVIS HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STAFFORD
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22554-7266
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-891-0040
Provider Business Mailing Address Fax Number:
540-699-6325

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2071 JEFFERSON DAVIS HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STAFFORD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22554-7266
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-891-0040
Provider Business Practice Location Address Fax Number:
540-699-6325
Provider Enumeration Date:
01/19/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FELEDY
Authorized Official First Name:
JULES
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
540-891-0040

Provider Taxonomy Codes

  • Taxonomy code: 208200000X , with the licence number:  0101237939 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2086S0122X , with the licence number: 0101237939 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)