{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "DENBIGH ORTHOPAEDICS & SPORTS MEDICINE, PC",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "12720 MCMANUS BLVD",
"SecondLineMailingAddress": "SUITE 311",
"MailingAddressCityName": "NEWPORT NEWS",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23602-4414",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "757-872-0548",
"MailingAddressFaxNumber": "757-872-0551",
"FirstLinePracticeLocationAddress": "12720 MCMANUS BLVD",
"SecondLinePracticeLocationAddress": "SUITE 311",
"PracticeLocationAddressCityName": "NEWPORT NEWS",
"PracticeLocationAddressStateName": "VA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "757-872-0548",
"PracticeLocationAddressFaxNumber": "757-872-0551",
"EnumerationDate": "03/25/2008",
"LastUpdateDate": "06/30/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STILES",
"AuthorizedOfficialFirstName": "THOMAS",
"AuthorizedOfficialMiddleName": "MARVIN",
"AuthorizedOfficialTitle": "OWNER/PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "757-872-0548",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "0101016325",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}