Individual
JONATHAN J CARMOUCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2331 FRANKLIN RD SW, ROANOKE, VA 24014-1111
(540) 510-6200
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101240988
VA
207XS0117X
Orthopaedic Surgery of the Spine Physician
0101-240988
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275562589
HEALTHKEEPERS PLUS
VA
05
—
1275562589
—
VA
01
—
371194700
BLACK LUNG
VA
01
—
3810018726
MEDICAID OF WEST VIRGINIA
VA
01
—
540506332108
TRICARE/CHAMPUS
VA
01
—
P00834687
RAILROAD MEDICARE
VA
Enumeration date
06/30/2006
Last updated
09/19/2025
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