Provider Demographics
NPI:1790814564
Name:JALBERT, BRIAN D (PA)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:D
Last Name:JALBERT
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Gender:M
Credentials:PA
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Mailing Address - Street 1:1330 OAK LANE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LYNCHBURG,
Mailing Address - State:VA
Mailing Address - Zip Code:24503
Mailing Address - Country:US
Mailing Address - Phone:434-847-6132
Mailing Address - Fax:434-845-4870
Practice Address - Street 1:7001 FOREST AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1726
Practice Address - Country:US
Practice Address - Phone:804-612-8282
Practice Address - Fax:804-612-8280
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2019-04-24
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Provider Licenses
StateLicense IDTaxonomies
VA0110001899363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant