Individual
DR. JACOB NEATHAWK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1802 BRAEBURN DR, SALEM, VA 24153-7357
(540) 772-3430
(540) 776-2051
Mailing address
1802 BRAEBURN DR, SALEM, VA 24153-7357
(540) 772-3430
(540) 776-2051
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101028129
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00277033
MEDICARE RAILROAD
VA
Enumeration date
01/13/2006
Last updated
11/29/2007
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