Individual
DR. JESSICA M. TSUKANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1250 E MARSHALL ST, DEPT. OF FAMILY MEDICINE AND POPULATION HEALTH, RICHMOND, VA 23298-5051
(804) 828-5883
(804) 828-5399
Mailing address
PO BOX 91734, RICHMOND, VA 23291-1734
(804) 358-6100
(804) 342-7619
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102204221
VA
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
0102204221
VA
Other
Enumeration date
07/24/2012
Last updated
09/22/2015
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