Individual
BENJAMIN TIMOTHY HOUSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
12715 WARWICK BLVD STE O, COMMONWEALTH FAMILY PRACTICE, NEWPORT NEWS, VA 23606-1800
(757) 930-0091
(757) 269-4406
Mailing address
856 J CLYDE MORRIS BLVD STE A, RIVERSIDE MEDICAL GROUP, NEWPORT NEWS, VA 23601-1318
(757) 594-4006
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110005454
VA
Other
Enumeration date
08/29/2016
Last updated
08/29/2016
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