Provider Demographics
NPI:1902018286
Name:DR. SCOTT J BIRCKBICHLER LLC
Entity Type:Organization
Organization Name:DR. SCOTT J BIRCKBICHLER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BIRCKBICHLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-497-8200
Mailing Address - Street 1:485 S INDEPENDENCE BLVD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1129
Mailing Address - Country:US
Mailing Address - Phone:757-497-8200
Mailing Address - Fax:757-497-8202
Practice Address - Street 1:485 S INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 111
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1129
Practice Address - Country:US
Practice Address - Phone:757-497-8200
Practice Address - Fax:757-497-8202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001955111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA199721OtherBCBS
VA5685214OtherCIGNA
VA199721OtherBCBS