Provider Demographics
NPI:1760680862
Name:ROMESBURG, JASON WILLIAM (DO)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:WILLIAM
Last Name:ROMESBURG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12127
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23612-2127
Mailing Address - Country:US
Mailing Address - Phone:757-867-6102
Mailing Address - Fax:
Practice Address - Street 1:3630 GEORGE WASHINGTON MEM HWY
Practice Address - Street 2:SUITE E
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23693-3350
Practice Address - Country:US
Practice Address - Phone:757-867-6102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2009-005692085R0202X
VA01022033702085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology