Individual
DR. KELVIN HORNBUCKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
885 KEMPSVILLE RD, SUITE 114, NORFOLK, VA 23502-3800
(757) 466-0165
(757) 466-7296
Mailing address
885 KEMPSVILLE RD, SUITE 114, NORFOLK, VA 23502-3800
(757) 466-0165
(757) 466-7296
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
0101230915
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659563799
GROUP NPI
VA
01
—
38219
OPTIMA
VA
01
—
441548
ANTHEM
VA
05
—
5857511
—
VA
01
—
7344610
AETNA
VA
05
—
89065F0
—
NC
Enumeration date
06/06/2006
Last updated
08/23/2007
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