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General NPI Number Information
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NPI Number | 1477695740
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Entity Type | Organization
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Legal Business Name | ART & SCIENCE OF OB-GYN, P.C.
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1101 FIRST COLONIAL RD SUITE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-2409
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Country | US
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Telephone | 757-481-3366
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Fax | 757-496-3889
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Provider Business Mailing Address
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Address Line | 1101 FIRST COLONIAL RD SUITE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-2409
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Country | US
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Telephone | 757-481-3366
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Fax | 757-496-3889
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAYMOND C LACKORE
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Credential | MD
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Telephone | 757-481-3366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101036490
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License Number State | VA
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