Individual
DR. JAYARATHNE KOTTAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 PARK HILL DR, FREDERICKSBURG, VA 22401-3387
(540) 368-7405
(540) 368-7599
Mailing address
1515 IDLEWILD BLVD, FREDERICKSBRG, VA 22401-6623
(240) 778-3761
(540) 368-7599
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101254569
VA
208100000X
Physical Medicine & Rehabilitation Physician
2004021469
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209339001
—
MO
Enumeration date
07/14/2006
Last updated
01/04/2024
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