Healthcare Provider Details

I. General information

NPI: 1497712756
Provider Name (Legal Business Name): HAMPTON ROADS PATHOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 11/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 BATTLEFIELD BLVD N CHESAPEAKE GENERAL HOSPITAL
CHESAPEAKE VA
23320-4906
US

IV. Provider business mailing address

PO BOX 1295
BLUEFIELD WV
24701-1295
US

V. Phone/Fax

Practice location:
  • Phone: 757-312-8121
  • Fax:
Mailing address:
  • Phone: 304-323-4320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LIONEL NEWMAN JACOB
Title or Position: PRESIDENT
Credential: MD
Phone: 757-312-8121