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NPI Code Detail

MEDICARE: DR. JEFFREY LYNN RIBLET M.D.

MEDICARE: DR. JEFFREY LYNN RIBLET M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12086S0102XSurgical Critical Care Physician0101049629VA
2208600000XSurgery Physician0101049629VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2890692OTHERVAMEDICARE RR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1463390OTHERVAANTHEM
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
415979OTHERVAOPTIMA

General Provider Information

NPI Number : 1336147719
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY LYNN RIBLET M.D.
Provider Business Mailing Address
First Line : 3640 HIGH ST
Second Line : SUITE 2F
City : PORTSMOUTH
State : VA
Zip : 23707-3213
Country : US
Telephone Number : 757-397-2383
Fax Number : 757-397-5201
Provider Business Practice Location Address
First Line : 3640 HIGH ST
Second Line : SUITE 2F
City : PORTSMOUTH
State : VA
Zip : 23707-3213
Country : US
Telephone Number : 757-397-2383
Fax Number : 757-397-5201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2005
Last Update Date : 07/21/2021

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