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SOUTHSIDE OB-GYN INC. NPI 1316150006


NPI Information

NPI: 1316150006
Provider Name: SOUTHSIDE OB-GYN, INC.
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
600 S SYCAMORE ST
PETERSBURG, VA
ZIP 23803
Phone: (804) 732-0136
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SOUTHSIDE OB-GYN, INC. is a specialist in Petersburg, VA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SOUTHSIDE OB-GYN, INC. NPI is 1316150006. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

600 S SYCAMORE ST
PETERSBURG, VA
ZIP 23803-815
Phone: (804) 732-0136
Fax: (804) 861-9661

The provider's authorized official is Henry Louis Tomlin .
The authorized official title is President and has the following contact phone number (804) 732-0136.

The enumeration date for this NPI number is 5/8/2007 and was last updated on 4/20/2008.


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
1174400000XSpecialist0101029081VIRGINIAYes

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 Other Provider Identifier Issuer
1212033OTHERVIRGINIACIGNA
2=========OTHERVIRGINIASOUTHERN HEALTH CARENET
3B09219MEDICARE UPINVIRGINIA
4213198OTHERVIRGINIAMDIPA OPTIMUM CHOICE
5C05445MEDICARE PINVIRGINIA
6=========OTHERVIRGINIATRICARE AND AETNA
7070725OTHERVIRGINIAANTHEM

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.