Healthcare Provider Details

I. General information

NPI: 1831109271
Provider Name (Legal Business Name): EARL C . STRAYHORN M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6160 KEMPSVILLE CIR SUITE 317 B
NORFOLK VA
23502-3933
US

IV. Provider business mailing address

6160 KEMPSVILLE CIR SUITE 317 B
NORFOLK VA
23502-3933
US

V. Phone/Fax

Practice location:
  • Phone: 757-461-4278
  • Fax: 757-461-1494
Mailing address:
  • Phone: 757-461-4278
  • Fax: 757-461-1494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number0101035788
License Number StateVA

VIII. Authorized Official

Name: MS. PATRICIA MARLENE BLOCKER-PALMER
Title or Position: PRACTICE ADMINISTRATOR
Credential: RN, BS, MA
Phone: 757-461-4278