Provider Demographics
NPI:1114246337
Name:DEVLIN, JILL A (DO)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:A
Last Name:DEVLIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 LAMB CIR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-6344
Mailing Address - Country:US
Mailing Address - Phone:540-731-4578
Mailing Address - Fax:540-731-0867
Practice Address - Street 1:2900 LAMB CIR
Practice Address - Street 2:SUITE 202
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-6344
Practice Address - Country:US
Practice Address - Phone:540-731-4578
Practice Address - Fax:540-731-0867
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0102-203814207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program