| |
304 E Leigh St Richmond VA 23219-1410 | |
(804) 225-7148 | |
(804) 225-7159 |
Full Name | |
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Speciality | Family Medicine |
Location | 304 E Leigh St, Richmond, Virginia |
Authorized Official Name and Position | George O Butler (DIRECTOR CORPORATE RESPONSIBILITIES) |
Authorized Official Contact | 8042810271 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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304 E Leigh St Richmond VA 23219-1410 Ph: (804) 225-7148 | 304 E Leigh St Richmond VA 23219-1410 Ph: (804) 225-7148 |
NPI Number | 1962705061 |
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Provider Enumeration Date | 12/10/2010 |
Last Update Date | 02/24/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962705061 | NPI | - | NPPES |
C06115 | Other | VA | GROUP PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 0101226755 (Virginia) | Primary |
Mary Brantley Holmes Msn Whnp-bc Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8955 Wishart Rd, Richmond, VA 23229 Phone: 804-928-5596 | |
Independent Associates Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7605 Forest Ave, Ste 211, Richmond, VA 23229 Phone: 804-282-3114 Fax: 804-285-9723 | |