Tidewater Mobile Medicine, Pllc
NPI #1225527351 in Portsmouth, Virginia
Provider Information
- NPI Number
- 1225527351
- Entity Type
- Organization
- Organization Name
- Tidewater Mobile Medicine, Pllc
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- TIDEWATER MOBILE MEDICINE PLLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- May 3, 2018
- Last Updated
- Jan 21, 2022
Practice Location
- Address
- 3520 HIGH ST STE 100
- City
- Portsmouth
- State
- Virginia
- ZIP Code
- 23707-3126
- Phone
- (757) 977-9675
Authorized Official
- Name
- DR. JIMMY COOPER JR., DHA, FNP-C
- Title
- CEO/OWNER
- Phone
- (757) 977-9675
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
| Social Worker - Clinical — Clinical |
| Clinic/Center - Primary Care — Primary Care |
| Non-emergency Medical Transport (VAN) |
| Family Medicine |
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