Provider Demographics
NPI:1083687099
Name:KAYOTA, STEPHEN W (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:W
Last Name:KAYOTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 FIRST COLONIAL RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-2418
Mailing Address - Country:US
Mailing Address - Phone:757-496-2325
Mailing Address - Fax:757-496-1942
Practice Address - Street 1:1120 FIRST COLONIAL RD
Practice Address - Street 2:SUITE 206
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2418
Practice Address - Country:US
Practice Address - Phone:757-496-2325
Practice Address - Fax:757-496-1942
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053621208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1083687099OtherAETNA
VA006802079Medicaid
VA1083687099OtherVIRGINIA HEALTH NETWORK
VA1083687099OtherHUMANA MEDICARE
VA1083687099OtherUNITED HEALTHCARE
VA1083687099OtherANTHEM BCBS VA
VA1083687099OtherCOVENTRY
VA1083687099OtherTRICARE
VA1083687099OtherOPTIMA
VA1083687099OtherCIGNA
VA1083687099OtherDEPARTMENT OF LABOR
VA1083687099OtherOPTIMA
VA1083687099OtherTRICARE
VA1083687099OtherCIGNA