Provider Demographics
NPI:1720197767
Name:NORFOLK DEPARTMENT OF PUBLIC HEALTH
Entity Type:Organization
Organization Name:NORFOLK DEPARTMENT OF PUBLIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEMETRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDSAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-683-2796
Mailing Address - Street 1:830 SOUTHAMPTON AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1001
Mailing Address - Country:US
Mailing Address - Phone:757-683-2796
Mailing Address - Fax:757-683-8878
Practice Address - Street 1:207 E LITTLE CREEK RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-2504
Practice Address - Country:US
Practice Address - Phone:757-531-2135
Practice Address - Fax:757-531-2113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA008450145Medicaid