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Organization
MARTHA JEFFERSON MEDICAL GROUP LLC
Active
Organization
MARTHA JEFFERSON MEDICAL GROUP LLC
Active
Parent organization
MARTHA JEFFERSON HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARTHA JEFFERSON HOSPITAL
Authorized official
DR. BRUCE CLEMONS MD (VICE PRESIDENT, MEDICAL DIRECTOR)
(434) 654-5229
Entity
Organization
Contact information
Practice address
590 PETER JEFFERSON PKWY STE 300, CHARLOTTESVILLE, VA 22911-4628
(434) 654-7340
(434) 654-7752
Mailing address
PO BOX 746550, ATLANTA, GA 30374-6550
(434) 654-7340
(434) 654-7752
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
VA
207RH0003X
Hematology & Oncology Physician
—
NULL
207RH0003X
Hematology & Oncology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
VA
207XS0106X
Orthopaedic Hand Surgery Physician
—
VA
208000000X
Pediatrics Physician
—
VA
208200000X
Plastic Surgery Physician
—
VA
208600000X
Surgery Physician
—
VA
208M00000X
Hospitalist Physician
—
VA
Other
Enumeration date
10/01/2007
Last updated
09/29/2022
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