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General NPI Number Information
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NPI Number | 1518676121
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Entity Type | Organization
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Legal Business Name | JEFF KATRA MEDICAL SERVICES. PLLC
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Dates
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Enumeration Date | 11/22/2022
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 631 BERKMAR CIR
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-1464
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Country | US
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Telephone | 434-400-9668
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Fax | 434-465-6018
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Provider Business Mailing Address
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Address Line | PO BOX 8041
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22906-8041
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Country | US
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Telephone | 804-282-9133
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Fax | 804-282-9135
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Authorized Official
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Title or Position | SOLE MEMBER OWNER
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Name | JEFF JASON KATRA
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Credential | DO
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Telephone | 570-690-4186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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