Provider Demographics
NPI:1285768465
Name:VIRGINIA MEDICAL SPECIALISTS, PLC
Entity type:Organization
Organization Name:VIRGINIA MEDICAL SPECIALISTS, PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-481-2515
Mailing Address - Street 1:1008 FIRST COLONIAL RD STE 103
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3071
Mailing Address - Country:US
Mailing Address - Phone:757-481-2515
Mailing Address - Fax:
Practice Address - Street 1:1008 FIRST COLONIAL RD STE 103
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3071
Practice Address - Country:US
Practice Address - Phone:757-481-2515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIRGINIA MEDICAL SPECIALISTS, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-16
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC05919Medicare Oscar/Certification