Healthcare Provider Details

I. General information

NPI: 1851612683
Provider Name (Legal Business Name): JASON BRADLEY BRILL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2010
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLDG H 2005 KNIGHT LN NAVY MEDICINE SUPPORT COMMAND, ATTN MEDICAL STAFF SERV
JACKSONVILLE FL
32212
US

IV. Provider business mailing address

4301 JONES BRIDGE RD
BETHESDA MD
20814-4799
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-7577
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberMD-21438
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2011-01265
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: