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General NPI Number Information
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NPI Number | 1376563809
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Entity Type | Organization
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Legal Business Name | WARDELL ORTHOPAEDICS PC
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 1020 BON SECOURS DRIVE SUITE 105
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City | SUFFOLK
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State | VA
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Zip | 23435
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Country | US
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Telephone | 757-215-1400
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Fax | 757-215-1410
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Provider Business Mailing Address
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Address Line | 1020 BON SECOURS DRIVE SUITE 105
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City | SUFFOLK
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State | VA
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Zip | 23435
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Country | US
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Telephone | 757-215-1400
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Fax | 757-215-1410
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | ELIZABETH T LESTER
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Credential |
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Telephone | 757-215-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 010103201
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License Number State | VA
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