Provider Demographics
NPI:1780810069
Name:DOMINGUS, JEFF LEWIS (DO)
Entity type:Individual
Prefix:DR
First Name:JEFF
Middle Name:LEWIS
Last Name:DOMINGUS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:375 MONTEVISTA AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:NC
Mailing Address - Zip Code:28752-3389
Mailing Address - Country:US
Mailing Address - Phone:828-803-9030
Mailing Address - Fax:
Practice Address - Street 1:1380 LITTLE SORRELL DR STE 100
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801
Practice Address - Country:US
Practice Address - Phone:540-433-4913
Practice Address - Fax:540-433-4915
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0102204875207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine