Individual
JACK KENNINGTON AYRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-7550
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-3150
(757) 953-0871
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101266126
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101266126
—
VA
Enumeration date
04/28/2017
Last updated
09/18/2025
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