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Individual

DR. NORMAN TACKTILL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6355 WALKER LN, SUITE 408, ALEXANDRIA, VA 22310-3245
(703) 719-5901
(703) 719-9629
Mailing address
6355 WALKER LN, SUITE 408, ALEXANDRIA, VA 22310-3245
(703) 719-5901
(703) 719-9629

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101031690
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6294065
VA
Enumeration date
09/12/2005
Last updated
07/08/2007
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