person
Jack T Witzenfeld, PA
Medical Physician Assistant in Chesapeake, Virginia
NPI 1093819377

Jack T Witzenfeld is a Medical Physician Assistant based in Virginia Beach, VA and is specialized in Medical. Jack T Witzenfeld practices in Chesapeake, VA and has the professional credentials of PA. The NPI Number for Jack T Witzenfeld is 1093819377 and holds a License No. 0110840299 (Virginia).

The current practice location address for Jack T Witzenfeld is 736 Battlefield Blvd N, Chesapeake, VA and can be reached out via phone at 757-490-9388 and via fax at 757-490-9401. You can also correspond with Jack T Witzenfeld through the mailing address at 4536 BONNEY RD, VIRGINIA BEACH, VA - 23462-3869 (mailing address contact number: 757-490-9388).

Location: 736 Battlefield Blvd N, Chesapeake, VA, 23462-3869
person
Provider Profile Details
NPI Number
1093819377
Provider Name
Jack T Witzenfeld
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
736 Battlefield Blvd N, Chesapeake, VA, 23462-3869
Phone Number
757-490-9388
Fax Number
757-490-9401
Provider Enumeration Date
09/08/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
970000664 01 MEDICARE RAILROAD
institution
Provider Business Practice Location Address Details
Address
736 Battlefield Blvd N
City
State
Zip
23320-4941
Phone Number
757-490-9388
Fax Number
757-490-9401
person
Provider Business Mailing Address Details
Address
736 Battlefield Blvd N
City
State
Zip
23320-4941
Phone Number
757-490-9388
Fax Number
757-490-9401
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
0110840299 (Virginia)
Definition
Definition to come...
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