Provider Demographics
NPI:1508837568
Name:BANKS, ALAN KIRK (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:KIRK
Last Name:BANKS
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 1:205 BUSINESS PARK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6535
Mailing Address - Country:US
Mailing Address - Phone:757-962-1083
Mailing Address - Fax:757-962-1254
Practice Address - Street 1:844 KEMPSVILLE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502
Practice Address - Country:US
Practice Address - Phone:757-261-0700
Practice Address - Fax:757-962-1254
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101037942207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherVIRGINIA HEALTH NETWORK
VA15792OtherSENTARA OHP/SHP
VA331151OtherANTHEM
VA263654OtherUNITED HEALTHCARE/MAMSI
NC890632BMedicaid
VA239044OtherMAMSI
VA320722OtherANTHEM BCBS
VAPAROtherAETNA
VAPAROtherMULTIPLAN
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA006096310Medicaid
VAPAROtherVIRGINIA PREMIER HEALTH
VA55933OtherOPTIMA
VAPAROtherCIGNA
VAPAROtherUSA MANAGED CARE
VA006083595Medicaid
NC0632BOtherNC BC/BS
VA-001OtherTRICARE/CHAMPUS
VAPAROtherCORVEL/CORCARE
VA060000685Medicare PIN
VA331151OtherANTHEM
VAE92543Medicare UPIN
VAPAROtherVIRGINIA PREMIER HEALTH
VA15792OtherSENTARA OHP/SHP