| Long Term Care Of Tidewater Pc | |
|
6160 Kempsville Cir Ste 325a Norfolk VA 23502-3933 | |
| (757) 917-5356 | |
| (757) 917-5141 |
| Full Name | Long Term Care Of Tidewater Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6160 Kempsville Cir Ste 325a, Norfolk, Virginia |
| Authorized Official Name and Position | Jayne Walter (CREDENTIALING) |
| Authorized Official Contact | 7579175356 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Long Term Care Of Tidewater Pc 110 Kingsley Ln Ste 312 Norfolk VA 23505-4618 Ph: (757) 917-5356 | Long Term Care Of Tidewater Pc 6160 Kempsville Cir Ste 325a Norfolk VA 23502-3933 Ph: (757) 917-5356 |
| NPI Number | 1033154430 |
|---|---|
| Provider Enumeration Date | 06/19/2006 |
| Last Update Date | 11/01/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033154430 | NPI | - | NPPES |
| CK3562 | Other | VA | RAILROAD MEDICARE GROUP # |
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