Healthcare Provider Details

I. General information

NPI: 1902852189
Provider Name (Legal Business Name): JEFFREY E HULL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2602 BUFORD RD
RICHMOND VA
23235-3422
US

IV. Provider business mailing address

2651 RADNOR PL
MIDLOTHIAN VA
23113-6496
US

V. Phone/Fax

Practice location:
  • Phone: 804-272-8806
  • Fax:
Mailing address:
  • Phone: 804-378-0102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: