Healthcare Provider Details

I. General information

NPI: 1033145404
Provider Name (Legal Business Name): JYI HOLD CO JORDAN-YOUNG INSTITUTE FOR ORTHOPED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5716 CLEVELAND ST SUITE 200
VIRGINIA BEACH VA
23462-1784
US

IV. Provider business mailing address

5716 CLEVELAND ST STE 200
VIRGINIA BEACH VA
23462-1784
US

V. Phone/Fax

Practice location:
  • Phone: 757-502-8570
  • Fax: 757-961-9767
Mailing address:
  • Phone: 757-502-8570
  • Fax: 757-961-9767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: JACK L SIEGEL
Title or Position: PRESIDENT
Credential: MD
Phone: 757-576-3500