Healthcare Provider Details

I. General information

NPI: 1033273354
Provider Name (Legal Business Name): NORFOLK DEPARTMENT OF PUBLIC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 SOUTHAMPTON AVE
NORFOLK VA
23510-1001
US

IV. Provider business mailing address

830 SOUTHAMPTON AVE
NORFOLK VA
23510-1001
US

V. Phone/Fax

Practice location:
  • Phone: 757-683-2796
  • Fax: 757-683-8878
Mailing address:
  • Phone: 757-683-2796
  • Fax: 757-683-8878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES R BOYD
Title or Position: BUSINESS MANAGER
Credential: MBA
Phone: 757-683-2796