Healthcare Provider Details

I. General information

NPI: 1215375191
Provider Name (Legal Business Name): LAURIE CHRISTINE HARRIS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAURIE CHRISTINE HOYT DO

II. Dates (important events)

Enumeration Date: 06/12/2013
Last Update Date: 12/19/2019
Certification Date: 12/19/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 EXECUTIVE DR STE A
HAMPTON VA
23666-2948
US

IV. Provider business mailing address

860 OMNI BLVD STE 101
NEWPORT NEWS VA
23606-4430
US

V. Phone/Fax

Practice location:
  • Phone: 757-825-4273
  • Fax: 757-825-4276
Mailing address:
  • Phone: 757-232-8769
  • Fax: 757-232-8875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0116026167
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: