| NPI | 1477068328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN L JONES Authorized Official 757-324-5674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2017-12-13 |