Individual
DR. JEAN KHARA CASILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1168 FIRST COLONIAL RD STE 200, VIRGINIA BEACH, VA 23454-2444
(757) 352-2020
(757) 352-2021
Mailing address
3241 WESTERN BRANCH BLVD STE A, CHESAPEAKE, VA 23321-5260
(757) 686-3508
(757) 686-0541
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101275998
VA
207Q00000X
Family Medicine Physician
57544
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/12/2016
Last updated
06/01/2023
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