Frederick, Jon Randall

Frederick, Jon Randall is an individual health care provider with primary practice located at 8260 Atlee Rd Emergency Dept, Mechanicsville VA 23116. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Frederick, Jon Randall can be contacted via phone (804) 764-6300.

Contact Information

Primary practice address
8260 Atlee Rd Emergency Dept Mechanicsville VA 23116
Phone: (804) 764-6300
Fax: (804) 764-6562
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101242098 Virginia
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 0101242098 Virginia

Profile Details

NPI number 1003997800
LBN Legal business name Frederick, Jon Randall
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Aug 21st, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003997800 NPPES
Virginia Other 12723963 CAQH

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