Provider Demographics
NPI:1619307170
Name:LAPOLE, JEFFREY (RT(R), RPA/RA, CV)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:LAPOLE
Suffix:
Gender:M
Credentials:RT(R), RPA/RA, CV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 BENTLEY DR
Mailing Address - Street 2:
Mailing Address - City:INWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:25428-3479
Mailing Address - Country:US
Mailing Address - Phone:304-229-0818
Mailing Address - Fax:
Practice Address - Street 1:160 EXETER DR
Practice Address - Street 2:SUITE 104
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22603-8614
Practice Address - Country:US
Practice Address - Phone:540-545-4674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-20
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0132000004243U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant