Individual
DR. JENNIFER MILLER GODBOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4000 COLISEUM DR, SUITE 280, HAMPTON, VA 23666-5906
(757) 722-7401
(757) 722-7404
Mailing address
4000 COLISEUM DR, SUITE 280, HAMPTON, VA 23666-5906
(757) 722-7401
(757) 722-7404
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101252263
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598939431
NPI
VA
Enumeration date
04/22/2008
Last updated
07/11/2013
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