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General NPI Number Information
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NPI Number | 1114089075
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Entity Type | Organization
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Legal Business Name | ATLANTIC OBSTETRICS & GYNOCOLOGY
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 3720 HOLLAND RD SUITE 101
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-2859
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Country | US
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Telephone | 757-463-1234
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Fax | 757-463-0453
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Provider Business Mailing Address
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Address Line | 3720 HOLLAND RD SUITE 101
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-2859
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Country | US
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Telephone | 757-463-1234
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Fax | 757-463-0453
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TIMOTHY JOSEPH HARDY
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Credential | MD
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Telephone | 757-463-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0101043703
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License Number State | VA
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