Healthcare Provider Details

I. General information

NPI: 1851739239
Provider Name (Legal Business Name): JINGQUAN JIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2013
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 LOFTIS BLVD STE 100
NEWPORT NEWS VA
23606-3069
US

IV. Provider business mailing address

6350 CENTER DR STE 200
NORFOLK VA
23502-4107
US

V. Phone/Fax

Practice location:
  • Phone: 757-873-9839
  • Fax:
Mailing address:
  • Phone: 757-231-5700
  • Fax: 757-213-5701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number2018-01319
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number0101288794
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: