Provider Demographics
NPI:1457096406
Name:WILLIAMSBURG LANDING INC
Entity Type:Organization
Organization Name:WILLIAMSBURG LANDING INC
Other - Org Name:WILLIAMSBURG LANDING CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RESIDENT FINANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-565-6516
Mailing Address - Street 1:5700 WILLIAMSBURG LANDING DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-3779
Mailing Address - Country:US
Mailing Address - Phone:757-565-6516
Mailing Address - Fax:757-565-6551
Practice Address - Street 1:5700 WILLIAMSBURG LANDING DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-3779
Practice Address - Country:US
Practice Address - Phone:757-565-6525
Practice Address - Fax:757-565-6551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty