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General NPI Number Information
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NPI Number | 1124080122
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Entity Type | Individual
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Provider Name | LINDA JOAN GEORGE MD
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Gender | Female
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 1856 COLONIAL MEDICAL CT SUITE A
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3075
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Country | US
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Telephone | 757-962-6262
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Fax | 757-962-1185
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Provider Business Mailing Address
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Address Line | 2364 UPPER GREENS PL
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-3587
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Country | US
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Telephone | 757-563-9291
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Fax | 757-962-1185
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101054067
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License Number State | VA
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