Provider Demographics
NPI:1699846121
Name:ORTHOPAEDIC ASSOCIATES OF VIRGINIA, LTD
Entity Type:Organization
Organization Name:ORTHOPAEDIC ASSOCIATES OF VIRGINIA, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMMERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-893-1700
Mailing Address - Street 1:6275 E VIRGINIA BEACH BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-2851
Mailing Address - Country:US
Mailing Address - Phone:757-461-1688
Mailing Address - Fax:757-455-5865
Practice Address - Street 1:953B WEST 21ST ST
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23517
Practice Address - Country:US
Practice Address - Phone:757-461-1688
Practice Address - Fax:757-455-5865
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOPAEDIC ASSOCIATES OF VIRGINIA, LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-13
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Single Specialty