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General NPI Number Information
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NPI Number | 1447674742
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Entity Type | Organization
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Legal Business Name | DELTA ONCOLOGY ASSOCIATES, P.C.
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Dates
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Enumeration Date | 02/07/2014
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Last Update Date | 02/07/2014
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Provider Practice Location Address
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Address Line | 355 CRAWFORD ST SUITE 102
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City | PORTSMOUTH
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State | VA
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Zip | 23704-2816
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Country | US
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Telephone | 757-397-3400
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Fax | 757-399-0371
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Provider Business Mailing Address
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Address Line | 355 CRAWFORD ST SUITE 300
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City | PORTSMOUTH
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State | VA
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Zip | 23704-2816
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Country | US
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Telephone | 757-396-6348
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Fax | 757-396-6121
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. AMANDA KAY GRIZZARD
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Credential |
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Telephone | 757-396-6348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471M2300X
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Taxonomy Name | Mammography Radiologic Technologist
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License Number | 0101058359
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License Number State | VA
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