# TRICARE MEDICAL CLINIC SUFFOLK

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NAVAL MEDICAL CENTER PORTSMOUTH
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1821501719
- **Legal business name:** NAVAL MEDICAL CENTER PORTSMOUTH
- **Authorized official:** WILLIAM M CONDON (BUMED UBO)
- **Authorized official phone:** (240) 401-3643

## Contact information

- **Practice address:** 1317 BALLAHACK RD, CHESAPEAKE, VA 23322-2499
- **Practice address phone:** (703) 681-9522
- **Mailing address:** 620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/14/2017
- **Last updated:** 11/14/2017