Healthcare Provider Details

I. General information

NPI: 1235724006
Provider Name (Legal Business Name): WILLIAM THOMAS MIDKIFF DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2021
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9727 AVIONICS LOOP SUITE 100, BUILDING LF-18
NORFOLK VA
23511
US

IV. Provider business mailing address

9727 AVIONICS LOOP SUITE 100, BUILDING LF-18
NORFOLK VA
23511
US

V. Phone/Fax

Practice location:
  • Phone: 757-341-4906
  • Fax:
Mailing address:
  • Phone: 757-341-4906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0102207365
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: