Healthcare Provider Details

I. General information

NPI: 1376522896
Provider Name (Legal Business Name): SOUTHAMPTON NEUROLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 01/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 COMMERCE PARK ROAD
FRANKLIN VA
23851-1226
US

IV. Provider business mailing address

177 COMMERCE PARK ROAD
FRANKLIN VA
23851-1226
US

V. Phone/Fax

Practice location:
  • Phone: 757-569-9524
  • Fax: 757-569-0504
Mailing address:
  • Phone: 757-569-9524
  • Fax: 757-569-0504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number0101049903
License Number StateVA

VIII. Authorized Official

Name: DR. WILLIAM H HIGHLANDER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 757-569-9524