Provider Demographics
NPI:1942189022
Name:MARTHA JEFFERSON HOSPITAL
Entity type:Organization
Organization Name:MARTHA JEFFERSON HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:THEXTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-654-8199
Mailing Address - Street 1:500 MARTHA JEFFERSON DR FL 4
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-4668
Mailing Address - Country:US
Mailing Address - Phone:434-654-8199
Mailing Address - Fax:434-654-7324
Practice Address - Street 1:2250 IVY RD STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4977
Practice Address - Country:US
Practice Address - Phone:434-654-4320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy