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NPI Code Detail

MEDICARE: DR. JEFFREY JOHN LAURENT M.D.

MEDICARE: DR. JEFFREY JOHN LAURENT 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
1207T00000XNeurological Surgery Physician0101239708VA

General Provider Information

NPI Number : 1386607257
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY JOHN LAURENT M.D.
Provider Business Mailing Address
First Line : 5716 CLEVELAND ST
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-1784
Country : US
Telephone Number : 757-490-4802
Fax Number : 757-625-1829
Provider Business Practice Location Address
First Line : 5716 CLEVELAND ST
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-1784
Country : US
Telephone Number : 757-490-4802
Fax Number : 757-625-1829
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2006
Last Update Date : 04/18/2023

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