MEDICARE: DR. JENNIE WEBB-WRIGHT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	0101057761	VA
2	207PH0002X	Hospice and Palliative Medicine (Emergency Medicine) Physician	0101057761	VA
3	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	0101057761	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00274618	OTHER	VA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	108345	OTHER	VA	ANTHEM BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	C06778	OTHER	VA	GROUP PTAN

General Provider Information

NPI Number	:	1346276417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIE WEBB-WRIGHT M.D.

Provider Business Mailing Address
First Line	:	8580 MAGELLAN PKWY
Second Line	:	BUILDING IV
City	:	RICHMOND
State	:	VA
Zip	:	23227-1149
Country	:	US
Telephone Number	:	804-627-5291
Fax Number	:	804-627-5370

Provider Business Practice Location Address
First Line	:	8580 MAGELLAN PKWY
Second Line	:	BUILDING IV
City	:	RICHMOND
State	:	VA
Zip	:	23227-1149
Country	:	US
Telephone Number	:	804-627-5291
Fax Number	:	804-627-5370

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	12/30/2010

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