Provider Demographics
NPI:1497859094
Name:JAMES A HALEY VA MEDICAL CENTER
Entity Type:Organization
Organization Name:JAMES A HALEY VA MEDICAL CENTER
Other - Org Name:DEPARTMENT OF VETERANS AFFAIRS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF, OPHTHALMOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:KIRK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-972-2000
Mailing Address - Street 1:13000 BRUCE B DOWNS BLVD
Mailing Address - Street 2:VIST COORDINATOR 130V
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-4745
Mailing Address - Country:US
Mailing Address - Phone:813-972-2000
Mailing Address - Fax:813-631-7142
Practice Address - Street 1:13000 BRUCE B DOWNS BLVD
Practice Address - Street 2:VIST COORDINATOR 130V
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4745
Practice Address - Country:US
Practice Address - Phone:813-972-2000
Practice Address - Fax:813-631-7142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management