Provider Demographics
NPI:1023645124
Name:LOYOLA, JAIME LUIS III (MD)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:LUIS
Last Name:LOYOLA
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:345 GRANBY ST STE 812
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1969
Mailing Address - Country:US
Mailing Address - Phone:267-566-8498
Mailing Address - Fax:
Practice Address - Street 1:1264 HILLOCK XING
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6749
Practice Address - Country:US
Practice Address - Phone:267-566-8498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101278154207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine