Individual
KATHRYN JOCKOVIC VILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1625 N GEORGE MASON DR, PATHOLOGY DEPT, ARLINGTON, VA 22205-3683
(703) 558-6566
(502) 456-4440
Mailing address
PO BOX 7308, ARLINGTON, VA 22207-0308
(800) 292-1387
(502) 456-4440
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0101251315
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0453382 01
—
MD
05
—
057000700
—
DC
01
—
1022-0011
CAREFIRST BC/BS
MD
05
—
1851507263
—
VA
01
—
P01185683
MEDICARE RR
VA
Enumeration date
05/15/2007
Last updated
08/06/2013
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