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General NPI Number Information
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NPI Number | 1417024837
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Entity Type | Organization
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Legal Business Name | U.S. NAVY
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 620 JOHN PAUL JONES CIRCLE NAVAL MEDICAL CENTER PORTSMOUTH
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City | PORTSMOUTH
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State | VA
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Zip | 23708
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Country | US
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Telephone | 757-953-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1755 MILL WOOD WAY
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City | SUFFOLK
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State | VA
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Zip | 23434-2348
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Country | US
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Telephone | 757-923-1779
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Fax |
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Authorized Official
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Title or Position | DEPARTMENT HEAD, ORTHO SURGERY
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Name | DR. CLAUDE ANDERSON
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Credential | M.D.
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Telephone | 757-953-1882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number | G77841
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License Number State | CA
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