Individual
JACKSON ELLIOT BARGERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-0669
Mailing address
1415 SWEET BRIAR AVE, NORFOLK, VA 23509-1433
(703) 350-1723
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
0102208853
VA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/10/2023
Last updated
08/13/2024
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