Jason Marsili
Individual provider Active NPI Contractor · Midlothian, VA
NPI 1912239252 · NPPES record last updated Feb 11, 2010
Key facts
- NPI
- 1912239252
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 2705113948 (VA)
- Practice address
- 14266 Camack TRL
Midlothian, VA 23114-4327 - Phone
- (804) 307-5109
- NPI assigned
- Feb 11, 2010
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2705113948 | VA | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 2705113948 | VA | Yes |
Addresses
Primary practice location
14266 Camack TRL
Midlothian, VA 23114-4327
Mailing address
14266 Camack TRL
Midlothian, VA 23114-4327
Phone (804) 307-5109
Other providers in Midlothian, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.