Individual
DR. JERRY LYNN MOTHERSHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
707 WESTOVER AVE, NORFOLK, VA 23507-1622
(757) 627-3876
(757) 627-3876
Mailing address
707 WESTOVER AVE, NORFOLK, VA 23507-1622
(757) 627-3876
(757) 627-3876
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101040838
VA
Other
Enumeration date
12/20/2006
Last updated
07/08/2007
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