Healthcare Provider Details

I. General information

NPI: 1336776897
Provider Name (Legal Business Name): JAMES DAVID BRODELL JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E LEIGH ST FL 12
RICHMOND VA
23298-5004
US

IV. Provider business mailing address

PO BOX 980257
RICHMOND VA
23298-0257
US

V. Phone/Fax

Practice location:
  • Phone: 804-628-2676
  • Fax:
Mailing address:
  • Phone: 804-828-9783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number0116040285
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: