Provider Demographics
NPI:1952548711
Name:VICTOR G NOEL
Entity type:Organization
Organization Name:VICTOR G NOEL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:NOEL
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:757-258-9006
Mailing Address - Street 1:PO BOX 791
Mailing Address - Street 2:
Mailing Address - City:LIGHTFOOT
Mailing Address - State:VA
Mailing Address - Zip Code:23090-0791
Mailing Address - Country:US
Mailing Address - Phone:757-258-9006
Mailing Address - Fax:
Practice Address - Street 1:6297 OLD MOORETOWN RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-1744
Practice Address - Country:US
Practice Address - Phone:757-258-9006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA31483011799251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management