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General NPI Number Information
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NPI Number | 1306250329
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Entity Type | Individual
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Provider Name | JEFFREY PADGETT PHYSICIAN ASSISTANT
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Gender | Male
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 07/05/2024
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Provider Practice Location Address
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Address Line | 1326 E LITTLE CREEK RD
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City | NORFOLK
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State | VA
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Zip | 23518-3952
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Country | US
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Telephone | 757-772-6122
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Fax |
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Provider Business Mailing Address
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Address Line | 747 J CLYDE MORRIS BLVD
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City | NEWPORT NEWS
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State | VA
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Zip | 23601-1538
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Country | US
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Telephone | 757-736-3680
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Fax | 757-599-0215
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 0100-004600
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110004600
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License Number State | VA
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