Provider Demographics
NPI:1184111502
Name:PAIGE, JOHN R
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:R
Last Name:PAIGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7296 QUAKER DR
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23437-8903
Mailing Address - Country:US
Mailing Address - Phone:757-793-0146
Mailing Address - Fax:
Practice Address - Street 1:7296 QUAKER DR
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23437-8903
Practice Address - Country:US
Practice Address - Phone:757-793-0146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No374U00000XNursing Service Related ProvidersHome Health Aide