Provider Demographics
NPI:1144207929
Name:SINCLAIR, JEFFREY SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:SINCLAIR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2280 OPITZ BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3362
Mailing Address - Country:US
Mailing Address - Phone:703-523-9750
Mailing Address - Fax:571-589-2001
Practice Address - Street 1:2280 OPITZ BLVD STE 320
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3362
Practice Address - Country:US
Practice Address - Phone:703-523-9750
Practice Address - Fax:571-589-2001
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2021-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101234982208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1144207929Medicaid
VA1144207929Medicaid
H93220Medicare UPIN