Provider Demographics
NPI:1619942273
Name:GARNETT, ALFRED R JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:R
Last Name:GARNETT
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:850 KEMPSVILLE RD
Mailing Address - Street 2:STE 100G
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3920
Mailing Address - Country:US
Mailing Address - Phone:757-261-5977
Mailing Address - Fax:757-275-9913
Practice Address - Street 1:850 KEMPSVILLE RD
Practice Address - Street 2:STE 100G
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3920
Practice Address - Country:US
Practice Address - Phone:757-261-5977
Practice Address - Fax:757-275-9913
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101032282207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006027041Medicaid
810000002Medicare ID - Type Unspecified
VA006027041Medicaid