Organization
VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE C WILLIAMS (CREDENTIALING COORDINATOR)
(757) 722-9961
Entity
Organization
Contact information
Practice address
5 TREEBARK PL, HAMPTON, VA 23666-2179
(757) 224-3811
Mailing address
5 TREEBARK PL, HAMPTON, VA 23666-2179
(757) 224-3811
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0001101054
VA
Other
Enumeration date
01/14/2008
Last updated
01/14/2008
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