Organization
HAMPTON ROADS PODIATRY PC
Active
Organization
HAMPTON ROADS PODIATRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUDOLPH CLINTON ANDERSON JR. (PRESIDENT)
(757) 497-0859
Entity
Organization
Contact information
Practice address
5241 PRINCESS ANNE ROAD SUITE 102, VA BEACH, VA 23462
(757) 497-0859
(757) 497-0976
Mailing address
5241 PRINCESS ANNE ROAD SUITE 102, VA BEACH, VA 23462
(757) 497-0859
(757) 497-0976
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
0103001041
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9304240
—
VA
Enumeration date
08/30/2006
Last updated
08/22/2020
Update your record
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