Provider Demographics
NPI:1548235427
Name:JAKUM, JOSHUA A (MD, FAAP)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:A
Last Name:JAKUM
Suffix:
Gender:M
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 748613
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8613
Mailing Address - Country:US
Mailing Address - Phone:434-295-1000
Mailing Address - Fax:540-829-4827
Practice Address - Street 1:633 SUNSET LN STE F
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3942
Practice Address - Country:US
Practice Address - Phone:540-829-4200
Practice Address - Fax:540-829-4827
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101234394208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH40097Medicare UPIN
VA010027411Medicare ID - Type Unspecified