# YOUR MEDICAL DOCTOR OF VIRGINIA, P.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225848674
- **Authorized official:** DR. BRANTLEY TILMAN JOLLY JR. MD (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (202) 643-1171

## Contact information

- **Practice address:** 1539 BROOKHAVEN DR, MC LEAN, VA 22101-4128
- **Practice address phone:** (703) 447-6897
- **Mailing address:** 1539 BROOKHAVEN DR, MC LEAN, VA 22101-4128

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/08/2025
- **Last updated:** 01/17/2025