Provider Demographics
NPI:1346276417
Name:WEBB-WRIGHT, JENNIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIE
Middle Name:
Last Name:WEBB-WRIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8580 MAGELLAN PKWY
Mailing Address - Street 2:BUILDING IV
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-1149
Mailing Address - Country:US
Mailing Address - Phone:804-627-5291
Mailing Address - Fax:804-627-5370
Practice Address - Street 1:8580 MAGELLAN PKWY
Practice Address - Street 2:BUILDING IV
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-1149
Practice Address - Country:US
Practice Address - Phone:804-627-5291
Practice Address - Fax:804-627-5370
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101057761207R00000X, 207PH0002X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207PH0002XAllopathic & Osteopathic PhysiciansEmergency MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00274618OtherRR MEDICARE
VA108345OtherANTHEM BCBS
VA010162289Medicaid
VAC06778OtherGROUP PTAN
G89113Medicare UPIN
VA010162289Medicaid