Organization
EMERGENCY PHYSICIAN OF TIDEWATER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AKSEL KEKLIK PA-C (PHYSICIAN ASSISTANT)
(757) 410-8879
Entity
Organization
Contact information
Practice address
4092 FOXWOOD DR, SUITE 101, VIRGINIA BEACH, VA 23462-5225
(757) 467-4200
(757) 467-4173
Mailing address
309 DOWNING DR, CHESAPEAKE, VA 23322-8703
(757) 410-8879
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
0110001528
VA
Other
Enumeration date
10/06/2006
Last updated
08/22/2020
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