Provider Demographics
NPI:1497220339
Name:JERLIN PODIATRY LLC
Entity Type:Organization
Organization Name:JERLIN PODIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:JERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:757-389-7367
Mailing Address - Street 1:808 BATTLEFIELD BLVD S
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-6611
Mailing Address - Country:US
Mailing Address - Phone:757-389-7367
Mailing Address - Fax:757-389-7671
Practice Address - Street 1:808 BATTLEFIELD BLVD S
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-6611
Practice Address - Country:US
Practice Address - Phone:757-389-7367
Practice Address - Fax:757-389-7671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty