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Contact Information

SOUTHSIDE HEAD N NECK SURGERY PROFESSIONAL CORP
930 SOUTH AVE.
SUITE 4B
COLONIAL HEIGHTS, VA23834
 Phone: 804-504-0530
 Fax: 804-504-0532
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for SOUTHSIDE HEAD N NECK SURGERY PROFESSIONAL CORP

NPI Number 1194803338
LBN Legal business name SOUTHSIDE HEAD N NECK SURGERY PROFESSIONAL CORP
Authorized official DAVID CANGCUESTA - (PHYSICIAN/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/02/2006
Last updated 07/01/2014 - About 12 years ago
Identifiers
VA License # 0101036702
VA Other 006555055 MEDICARE RAILROAD
VA Other 040009007 MEDICARE RAILROAD
VA Other P00002082 MEDICARE RAILROAD
VA Other P00002088 MEDICARE RAILROAD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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