NPI 1013071794

Jacob Theodoor Moll, MD

Practitioner Aerospace Medicine Physician Danville, VA

Practice location

Address: 723 Piney Forest Rd, Danville, VA 24540-2860
Phone: (434) 773-6830
Fax: (434) 773-6832
Mailing address: 570 Country Place Rd, Axton, VA 24054-2566

Registered specialties

Aerospace Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2083A0100X Licence 0101019920 (VA)

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Registry record

NPI: 1013071794
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Dec 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.