Organization
PENINSULA PULMONARY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORRAINE LINDSAY WATKINS (ADMINISTRATOR)
(757) 594-3084
Entity
Organization
Contact information
Practice address
500 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1929
(757) 594-2732
Mailing address
500 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1929
(757) 594-2732
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000006899
ANTHEM GROUP PROVIDER
VA
Enumeration date
08/08/2006
Last updated
03/03/2008
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