Provider Demographics
NPI:1992713697
Name:NAIR, JAYALAKSHMI (MD)
Entity type:Individual
Prefix:DR
First Name:JAYALAKSHMI
Middle Name:
Last Name:NAIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JAYA
Other - Middle Name:
Other - Last Name:NAIR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8988 LORTON STATION BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-4756
Mailing Address - Country:US
Mailing Address - Phone:703-780-2800
Mailing Address - Fax:703-780-0461
Practice Address - Street 1:8988 LORTON STATION BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-4756
Practice Address - Country:US
Practice Address - Phone:703-780-2800
Practice Address - Fax:703-780-0461
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239772207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010373760Medicaid
VA010373760Medicaid