Provider Demographics
NPI:1184878209
Name:FLOOD, JILL TAYLOR (MD)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:TAYLOR
Last Name:FLOOD
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 1:844 FIRST COLONIAL RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-6185
Mailing Address - Country:US
Mailing Address - Phone:757-428-0002
Mailing Address - Fax:
Practice Address - Street 1:844 FIRST COLONIAL RD
Practice Address - Street 2:SUITE 202
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-6185
Practice Address - Country:US
Practice Address - Phone:757-428-0002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039530207V00000X, 207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006259979Medicaid
VA006259979Medicaid
VA160000809Medicare PIN