DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. RANDY WAIN CONNOLLY, DO, MPH

Active Sole Proprietor

DR. RANDY WAIN CONNOLLY, DO, MPH is a 2083A0100X healthcare provider located in PORTSMOUTH, Virginia. NPI 1164594628 is currently active in the NPPES registry. Verify at CMS.

2083A0100X · PORTSMOUTH, VA

Registration Details

NPI Number
1164594628
Provider Type
Individual
Gender
Male
NPI Issued
Nov 13, 2006 (19.708429507716 yrs)
Last Updated
May 31, 2023
Licenses
0102201963 (VA)
0102201963 (VA)
Sole Proprietor
Yes

Practice Information

Address
620 JOHN PAUL JONES CIR STE 1100
PORTSMOUTH, VA, 237082111
Browse VA providers · Browse ZIP 23708
Phone
7579530765
Primary Specialty
2083A0100X
2083A0100X
Additional Specialty
2083A0100X

Other 2083A0100X Providers in PORTSMOUTH, VA

Name Credential NPI
DR. DAVID ALLEN HILAND D.O. 1114953171
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.