On Call Psychiatry | |
751 Thimble Shoals Blvd Ste N Newport News VA 23606-3563 | |
(757) 223-0500 | |
Not Available |
Full Name | On Call Psychiatry |
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Speciality | Counselor |
Location | 751 Thimble Shoals Blvd Ste N, Newport News, Virginia |
Authorized Official Name and Position | Michael Clinton C Tyson (DIRECTOR OF OPERATIONS) |
Authorized Official Contact | 2097693420 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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On Call Psychiatry 8 Royal Oak Ct Hampton VA 23666-6033 Ph: (757) 223-0500 | On Call Psychiatry 751 Thimble Shoals Blvd Ste N Newport News VA 23606-3563 Ph: (757) 223-0500 |
NPI Number | 1013469923 |
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Provider Enumeration Date | 10/26/2016 |
Last Update Date | 10/26/2016 |
Medicare PECOS PAC ID | 8729363627 |
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Medicare Enrollment ID | O20170315001868 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013469923 | NPI | - | NPPES |
Provider Name | Craig Allen Tyson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720342272 PECOS PAC ID: 5799935714 Enrollment ID: I20121026000501 |
Provider Name | Thomas J Kannon |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396112538 PECOS PAC ID: 6608165568 Enrollment ID: I20160516001728 |
Provider Name | Vonetta Thompson |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1598949067 PECOS PAC ID: 4587930029 Enrollment ID: I20171027000537 |
Provider Name | Reginald T Russell |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811121551 PECOS PAC ID: 3577883719 Enrollment ID: I20230522002129 |
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