Provider Demographics
NPI:1275874539
Name:PSYCHIATRIC CONSULTANTS OF HAMPTON ROADS
Entity Type:Organization
Organization Name:PSYCHIATRIC CONSULTANTS OF HAMPTON ROADS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:YETTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-651-2973
Mailing Address - Street 1:4458B LOOKOUT RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-1541
Mailing Address - Country:US
Mailing Address - Phone:757-651-2973
Mailing Address - Fax:
Practice Address - Street 1:4458B LOOKOUT RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-1541
Practice Address - Country:US
Practice Address - Phone:757-651-2973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Single Specialty