Organization
BON SECOURS MEDICAL GROUP HAMPTON ROADS SPECIALTY CARE LLC
Active
Other names
SOUTHAMPTON ORTHOPAEDIC AND SPORTS MEDICINE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
WILBUR GAY (CFO)
(864) 255-1904
Entity
Organization
Contact information
Practice address
2790 GODWIN BLVD STE 320, SUFFOLK, VA 23434-8174
(757) 562-7301
(757) 562-7305
Mailing address
8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
(866) 496-9229
(866) 449-0896
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/12/2020
Last updated
12/10/2020
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