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General NPI Number Information
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NPI Number | 1285806786
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Entity Type | Organization
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Legal Business Name | DENBIGH ORTHOPAEDICS & SPORTS MEDICINE, PC
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Dates
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Enumeration Date | 03/25/2008
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Last Update Date | 06/30/2010
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Provider Practice Location Address
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Address Line | 12720 MCMANUS BLVD SUITE 311
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City | NEWPORT NEWS
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State | VA
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Zip | 23602-4414
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Country | US
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Telephone | 757-872-0548
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Fax | 757-872-0551
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Provider Business Mailing Address
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Address Line | 12720 MCMANUS BLVD SUITE 311
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City | NEWPORT NEWS
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State | VA
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Zip | 23602-4414
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Country | US
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Telephone | 757-872-0548
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Fax | 757-872-0551
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. THOMAS MARVIN STILES
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Credential | M.D.
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Telephone | 757-872-0548
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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 | 0101016325
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License Number State | VA
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