Provider Demographics
NPI:1538141338
Name:HERSHEY, J H (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:J
Middle Name:H
Last Name:HERSHEY
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2080
Mailing Address - Street 2:
Mailing Address - City:KILMARNOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22482-2080
Mailing Address - Country:US
Mailing Address - Phone:804-435-3508
Mailing Address - Fax:
Practice Address - Street 1:210 PEPPER ST S
Practice Address - Street 2:SUITE A
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-3522
Practice Address - Country:US
Practice Address - Phone:540-381-7100
Practice Address - Fax:540-381-7108
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2008-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101-035870207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010135877Medicaid
VA1538141338Medicaid
VA1538141338Medicaid
003748C51Medicare PIN
VA010135877Medicaid
006099C95Medicare PIN
014951C47Medicare PIN