Organization
FAMILY PHYSICIANS OF TIDEWATER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLEMENT STOKES KIRKLAND JR. M.D. (PRESIDENT)
(757) 889-6520
Entity
Organization
Contact information
Practice address
110 KINGSLEY LN, SUITE 202, NORFOLK, VA 23505-4614
(757) 889-6520
(757) 489-4905
Mailing address
110 KINGSLEY LN, SUITE 202, NORFOLK, VA 23505-4614
(757) 889-6520
(757) 489-4905
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/25/2007
Last updated
08/22/2020
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