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Specialty details in registry · Newport News, VA

Call (757) 696-9599 Directions

At a glance

1204 73Rd St, Newport News, VA 23605-1816

NPPES record updated Oct 6, 2021. Public records can lag behind changes at a practice.

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Practice location

1204 73Rd St
Newport News, VA 23605-1816

Professional details: NPI, taxonomy & registry record

NPI1619551223

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 343900000X
Enumeration date: May 10, 2021
Record updated: Oct 6, 2021

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

343900000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

1204 73Rd St
Newport News, VA 23605-1816

Phone: (757) 696-9599

Mailing address

1204 73RD ST

NEWPORT NEWS, VA 236051816

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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