Organization
BMC NORFOLK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN A GUNKLE IDC (INDEPENDENT DUTY CORPSMAN)
(757) 953-8739
Entity
Organization
Contact information
Practice address
BRANCH MEDICAL CLINIC, 1721 TAUSSIG BLVD, NORFOLK, VA 23511
(757) 953-8739
Mailing address
9721 7TH BAY ST, NORFOLK, VA 23518-1231
(757) 953-8739
Taxonomy
Speciality
Code
Description
License number
State
261QM1101X
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710I1002X
INDEPENDENT DUTY CORPSMAN
VA
Enumeration date
06/29/2006
Last updated
08/07/2008
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