Provider Demographics
NPI:1669633319
Name:KAHLON, JAGDEEP KAUR (MD)
Entity Type:Individual
Prefix:
First Name:JAGDEEP
Middle Name:KAUR
Last Name:KAHLON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12325 COUNTRYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5337
Mailing Address - Country:US
Mailing Address - Phone:304-388-1000
Mailing Address - Fax:304-388-1041
Practice Address - Street 1:13901 COALFIELD COMMONS PL
Practice Address - Street 2:SUITE 102
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-1216
Practice Address - Country:US
Practice Address - Phone:804-378-0800
Practice Address - Fax:804-378-0900
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2020-02-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01012539782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1669633319Medicaid