Individual
JACOB LANTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12200 WARWICK BLVD, SUITE 480, NEWPORT NEWS, VA 23601-2344
(757) 838-5055
(757) 827-0129
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
(757) 316-5900
(757) 534-5190
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101254902
VA
207XX0801X
Orthopaedic Trauma Physician
Primary
0101254902
VA
Other
Enumeration date
04/01/2009
Last updated
06/22/2016
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