| Organization Name: | HAMPTON ROADS PODIATRY PC |
| NPI Number: | 1538279260 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RUDOLPH CLINTON ANDERSON (PRESIDENT) |
| Mailing Address: | 5241 Princess Anne Road Suite 102 Va Beach |
| State: | VA US |
| Postal Code: | 23462 |
| Phone Number: | 7574970859 |
| Fax Number: | 7574970976 |
| NPI Enumeration Date: | 08/30/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | 0103001041 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |