Provider Demographics
NPI:1952381535
Name:VILLARS, JEAN FREDERICK (MD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:FREDERICK
Last Name:VILLARS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2307 DELANCEY PL
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-6406
Mailing Address - Country:US
Mailing Address - Phone:215-546-6992
Mailing Address - Fax:
Practice Address - Street 1:2307 DELANCEY PL
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-6406
Practice Address - Country:US
Practice Address - Phone:215-546-6992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD026815E2084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEC33239Medicare UPIN
DE008901C60Medicare PIN