Basic Information
| Provider Information | |||||||||
| NPI: | 1053390666 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VIRGIN ISLAND ORTHOPEDICS AND SPORTS MEDICINE P C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8360 | ||||||||
| Address2: | |||||||||
| City: | ST THOMAS | ||||||||
| State: | VI | ||||||||
| PostalCode: | 008011360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3407142845 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9149 ESTATE THOMAS | ||||||||
| Address2: | PARAGON MEDICAL BUILDING SUITE 104 | ||||||||
| City: | ST THOMAS | ||||||||
| State: | VI | ||||||||
| PostalCode: | 008022615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3407142845 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | CHASE | ||||||||
| AuthorizedOfficialFirstName: | JEFFREY | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3407142845 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | 2509 | VI | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 225100000X | 131 | VI | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 363A00000X | 068 | VI | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 174400000X | 1122 | VI | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.