Individual
WILLIAM L OLD III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 J CLYDE MORRIS BLVD, STE 602, NEWPORT NEWS, VA 23601-1929
(757) 534-5511
(757) 534-5515
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
(757) 594-4006
(757) 594-2195
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
0101035691
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010285216
—
VA
05
—
1386679967
—
VA
01
—
P00360212
RAILROAD
VA
Enumeration date
07/11/2006
Last updated
08/28/2009
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