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Individual

DR. JEFFREY H WIDMEYER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7626 TIMBERLAKE RD, LYNCHBURG, VA 24502-2325
(434) 847-5347
(434) 316-7008
Mailing address
7626 TIMBERLAKE RD, LYNCHBURG, VA 24502-2325
(434) 847-5347
(434) 316-7008

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
0101049993
VA
208600000X
Surgery Physician
0101049993
VA
2086S0129X
Vascular Surgery Physician
010104993
VA
2086S0129X
Vascular Surgery Physician
Primary
0101049993
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
176753
ANTHEM
VA
01
462534
SOUTHERN HEALTH
VA
01
7187888
AETNA
VA
01
P00237590
RAILROAD MEDICARE
VA
Enumeration date
08/19/2006
Last updated
03/08/2024
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