Robert Reid Nottingham Jr., CSA
Physician Assistant, Surgical in Arlington, VA. Individual provider (NPI-1).
NPI number1164080321
StatusActive
Last updated in NPPESJun 5, 2023
Details
- NPI
- 1164080321
- Entity type
- Individual (NPI-1)
- Name
- Mr. Robert Reid Nottingham Jr.
- Credential
- CSA
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 3, 2019
- Certification date
- Jun 5, 2023
- Last updated
- Jun 5, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | – | VA | Yes |
| 246ZC0007X | Specialist/Technologist, Other, Surgical Assistant | 5016 | VA |
Practice location
2300 Wilson Blvd Ste 700Arlington, VA 22201-5435
Phone 757-439-0033
Mailing address
2300 Wilson Blvd Ste 700Arlington, VA 22201-5435
Phone 757-439-0033
Other practice locations
8116 Arlington Blvd Ste 183
Falls Church, VA 22042-1002
Falls Church, VA 22042-1002
Phone 703-659-4557
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