Individual
JON CHRISTOPHER BRILLHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2929 LONDON BLVD, PORTSMOUTH, VA 23707-3405
(757) 397-1201
(757) 398-0809
Mailing address
PO BOX 7429, PORTSMOUTH, VA 23707-0429
(785) 767-3050
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001199
VA
363AS0400X
Surgical Physician Assistant
0110001199
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010073871
—
VA
Enumeration date
06/01/2005
Last updated
06/11/2024
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