Healthcare Provider Details

I. General information

NPI: 1912493990
Provider Name (Legal Business Name): JOSHUA EVERETT BRINKMAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 07/21/2021
Certification Date: 07/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2017 PLEASURE HOUSE RD
VIRGINIA BEACH VA
23455-2709
US

IV. Provider business mailing address

2017 PLEASURE HOUSE RD
VIRGINIA BEACH VA
23455-2709
US

V. Phone/Fax

Practice location:
  • Phone: 757-318-6900
  • Fax: 757-318-6901
Mailing address:
  • Phone: 757-318-6900
  • Fax: 757-318-6901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOT018355
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102206540
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: