Provider Demographics
NPI:1689641193
Name:KAISER, JOHN R (MD)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:R
Last Name:KAISER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 SENTARA CIR
Mailing Address - Street 2:ROOM 2C
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-5713
Mailing Address - Country:US
Mailing Address - Phone:757-984-7217
Mailing Address - Fax:757-984-7210
Practice Address - Street 1:100 SENTARA CIRCLE
Practice Address - Street 2:ROOM 2C
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-5714
Practice Address - Country:US
Practice Address - Phone:757-984-7217
Practice Address - Fax:757-984-7210
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2016-01-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101031836207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0005818907Medicaid
VA0005818907Medicaid
B08040Medicare UPIN