Organization
TELE-PHYSICIANS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANTLEY T JOLLY MD (CHIEF MEDICAL OFFICER)
(571) 224-1069
Entity
Organization
Contact information
Practice address
1768 BUSINESS CENTER DR, SUITE 100, RESTON, VA 20190-5324
(703) 225-7104
Mailing address
1768 BUSINESS CENTER DR, SUITE 100, RESTON, VA 20190-5324
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2084V0102X
Vascular Neurology Physician
Primary
—
—
Other
Enumeration date
07/03/2014
Last updated
10/12/2018
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