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General NPI Number Information
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NPI Number | 1467800599
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Entity Type | Organization
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Legal Business Name | XIAO HONG JIN MD PLLC
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Dates
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Enumeration Date | 05/31/2016
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 15 GOODRICH AVE
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City | PETERSBURG
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State | VA
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Zip | 23805-2119
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Country | US
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Telephone | 804-732-0618
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Fax | 804-861-6846
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Provider Business Mailing Address
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Address Line | 11619 RIVERBOAT DR
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City | CHESTER
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State | VA
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Zip | 23836-5438
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Country | US
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Telephone | 804-943-3695
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Fax | 804-861-6846
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | XIAO HONG JIN
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Credential | MD
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Telephone | 804-732-0618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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