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Individual

DR. JOHN M JACOCKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
FBCH - AVIATION MEDICINE CLINIC, 9300 DEWITT LOOP, FORT BELVOIR, VA 22060
(571) 231-7334
Mailing address
9815 S PARK CIR, FAIRFAX STATION, VA 22039-2908
(703) 440-1088
(703) 806-3591

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
7019
HI
2083A0100X
Aerospace Medicine Physician
Primary
7019
HI

Other

Enumeration date
10/31/2005
Last updated
04/27/2022
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