Provider Demographics
NPI:1801142229
Name:UNIVERSITY OF VIRGINIA
Entity type:Organization
Organization Name:UNIVERSITY OF VIRGINIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DESIGNATED INSTITUTIONAL OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-924-0401
Mailing Address - Street 1:1925 BEECHCREST CT
Mailing Address - Street 2:UNIT 203
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-6625
Mailing Address - Country:US
Mailing Address - Phone:434-284-3720
Mailing Address - Fax:
Practice Address - Street 1:1925 BEECHCREST COURT
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903
Practice Address - Country:US
Practice Address - Phone:434-284-3720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-03
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital