Healthcare Provider Details

I. General information

NPI: 1609944545
Provider Name (Legal Business Name): VIRGINIA ORTHOPEDIC AND SPORTS MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5335 DISCOVERY PARK BLVD SUITE B
WILLIAMSBURG VA
23188
US

IV. Provider business mailing address

5335 DISCOVERY PARK BLVD SUITE B
WILLIAMSBURG VA
23188
US

V. Phone/Fax

Practice location:
  • Phone: 757-253-0603
  • Fax: 757-645-2701
Mailing address:
  • Phone: 757-253-0603
  • Fax: 757-645-2701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. BEV PERRIE
Title or Position: MANAGER
Credential:
Phone: 757-253-0603