Provider Demographics
NPI:1861900110
Name:JULES A. FELEDY, JR., MD., PLLC
Entity type:Organization
Organization Name:JULES A. FELEDY, JR., MD., PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULES
Authorized Official - Middle Name:A
Authorized Official - Last Name:FELEDY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:540-891-0040
Mailing Address - Street 1:2071 JEFFERSON DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-7266
Mailing Address - Country:US
Mailing Address - Phone:540-891-0040
Mailing Address - Fax:540-699-6325
Practice Address - Street 1:2071 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-7266
Practice Address - Country:US
Practice Address - Phone:540-891-0040
Practice Address - Fax:540-699-6325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-19
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237939208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty