Organization
BEACH EAR NOSE THROAT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM SWAIN TEACHEY MD (PRESIDENT)
(757) 464-9165
Entity
Organization
Contact information
Practice address
1020 INDEPENDENCE BLVD, SUITE 313, VA BEACH, VA 23455
(757) 464-9165
(757) 464-4478
Mailing address
1020 INDEPENDENCE BLVD, SUITE 313, VA BEACH, VA 23455
(757) 464-9165
(757) 464-4478
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0101027211
VA
207Y00000X
Otolaryngology Physician
16027
NC
207Y00000X
Otolaryngology Physician
ME17505
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6561781
—
VA
Enumeration date
09/07/2011
Last updated
12/27/2012
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