Provider Demographics
NPI:1851739239
Name:JIA, JINGQUAN (MD)
Entity Type:Individual
Prefix:
First Name:JINGQUAN
Middle Name:
Last Name:JIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DUMC BOX # 3052
Mailing Address - Street 2:10 BRYAN SEARLE DRIVE, SEELEY G. MUDD BLDG.
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710
Mailing Address - Country:US
Mailing Address - Phone:919-681-5257
Mailing Address - Fax:919-613-5228
Practice Address - Street 1:20 DUKE MEDICINE DRIVE
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710
Practice Address - Country:US
Practice Address - Phone:919-681-5257
Practice Address - Fax:919-613-5228
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01319207RX0202X
NC2018-01319207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology