Healthcare Provider Details

I. General information

NPI: 1770613895
Provider Name (Legal Business Name): VANN-VIRGINIA CENTER FOR ORTHOPAEDICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 05/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 KINGSLEY LN SUITE 405
NORFOLK VA
23505
US

IV. Provider business mailing address

230 CLEARFIELD AVE SUITE 124
VIRGINIA BEACH VA
23462-1832
US

V. Phone/Fax

Practice location:
  • Phone: 757-321-3300
  • Fax: 757-321-3332
Mailing address:
  • Phone: 757-321-3383
  • Fax: 757-321-3332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number0101041556
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEBRA HOGGE
Title or Position: BUSINESS OFFICE MANGER
Credential:
Phone: 757-321-3398