Healthcare Provider Details

I. General information

NPI: 1942798004
Provider Name (Legal Business Name): DIANA LEIGH ALSBROOK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2018
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12200 WARWICK BLVD STE 110
NEWPORT NEWS VA
23601-2344
US

IV. Provider business mailing address

2500 N STATE ST
JACKSON MS
39216-4500
US

V. Phone/Fax

Practice location:
  • Phone: 757-534-5395
  • Fax:
Mailing address:
  • Phone: 901-517-7607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number0101288306
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME158198
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: