Donald Irby
Individual provider Active NPI Contractor · Hampton, VA
NPI 1063985356 · NPPES record last updated Jan 9, 2019
Key facts
- NPI
- 1063985356
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 59104B (NJ)
- Practice address
- 445 Chapel St
Hampton, VA 23669-3912 - Phone
- (757) 287-2695
- NPI assigned
- Jan 9, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59104B | NJ | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 59104B | NJ | Yes |
Addresses
Primary practice location
445 Chapel St
Hampton, VA 23669-3912
Mailing address
445 Chapel St
Hampton, VA 23669-3912
Phone (757) 287-2695
Other providers in Hampton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.