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General NPI Number Information
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NPI Number | 1275808321
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Entity Type | Organization
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Legal Business Name | VETERANS ADMINISTRATION MEDICAL CENTER
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Dates
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Enumeration Date | 03/21/2012
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Last Update Date | 03/21/2012
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Provider Practice Location Address
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Address Line | 100 EMANCIPATION DR
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City | HAMPTON
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State | VA
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Zip | 23667-0001
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Country | US
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Telephone | 757-722-9961
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Fax | 757-728-3173
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Provider Business Mailing Address
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Address Line | 100 EMANCIPATION DR
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City | HAMPTON
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State | VA
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Zip | 23667-0001
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Country | US
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Telephone | 757-722-9961
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Fax | 757-728-3173
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Authorized Official
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Title or Position | CHIEF OF PROSTHETICS
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Name | MR. ROBERT CLAYBORN
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Credential | CO
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Telephone | 757-722-9961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2865M2000X
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Taxonomy Name | Military General Acute Care Hospital
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License Number |
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License Number State |
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