Organization
OLD HAMPTON FAMILY MEDICAL ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANN SHAW (OFFICE MANAGER)
(757) 728-1100
Entity
Organization
Contact information
Practice address
26 WINE ST, HAMPTON, VA 23669-3584
(757) 728-1100
(757) 728-0870
Mailing address
26 WINE ST, HAMPTON, VA 23669-3584
(757) 728-1100
(757) 728-0870
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005114
ANTHEM
VA
05
—
5637341
—
VA
Enumeration date
03/01/2007
Last updated
02/11/2010
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