Basic Information
| Provider Information | |||||||||
| NPI: | 1548424161 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLOWERS | ||||||||
| FirstName: | JONAH | ||||||||
| MiddleName: | RENA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | FLOWERS | ||||||||
| OtherFirstName: | JONAH | ||||||||
| OtherMiddleName: | RENA | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | D.O. | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 150 KINGSLEY LANE | ||||||||
| Address2: | SUITE 4000 | ||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7578894280 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 150 KINGSLEY LANE | ||||||||
| Address2: | SUITE 4000 | ||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7578894280 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2008 | ||||||||
| LastUpdateDate: | 03/12/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0116020616 | VA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 0102203036 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.