Provider Demographics
NPI:1235483348
Name:JABBOUR, JOSEPH MITCHELL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MITCHELL
Last Name:JABBOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:22071 SAM FRED RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20117-3201
Mailing Address - Country:US
Mailing Address - Phone:540-687-6607
Mailing Address - Fax:540-687-6607
Practice Address - Street 1:22071 SAM FRED RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:VA
Practice Address - Zip Code:20117-3201
Practice Address - Country:US
Practice Address - Phone:540-687-6607
Practice Address - Fax:540-687-6607
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-29
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101054565208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery