TIDEWATER PODIATRY GROUP LTD NPI 1356542922

NPI Information

NPI: 1356542922
Provider Name: TIDEWATER PODIATRY GROUP LTD
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
6161 KEMPSVILLE CIR
STE 230
NORFOLK, VA
ZIP 23502
Phone: (757) 481-6248
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TIDEWATER PODIATRY GROUP LTD is a foot and ankle surgery podiatrist in Norfolk, VA. TIDEWATER PODIATRY GROUP LTD NPI is 1356542922. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6161 KEMPSVILLE CIR
STE 230
NORFOLK, VA
ZIP 23502-932
Phone: (757) 481-6248

The provider's authorized official is Jay Tischler .
The authorized official title is President and has the following contact phone number (757) 481-6248.

The enumeration date for this NPI number is 5/30/2007 and was last updated on 11/7/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery		VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	T21387	MEDICARE UPIN	VIRGINIA
2	C01098	MEDICARE PIN	VIRGINIA
3	0767720001	MEDICARE NSC	VIRGINIA
4	T21531	MEDICARE UPIN	VIRGINIA
5	CC6300	MEDICARE PIN	VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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