Dominion Medical Associates, Inc | |
304 E Leigh St Richmond VA 23219-1410 | |
(804) 225-7148 | |
(804) 225-7159 |
Full Name | Dominion Medical Associates, Inc |
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Speciality | Internal Medicine |
Location | 304 E Leigh St, Richmond, Virginia |
Authorized Official Name and Position | Richard Allen Jackson (PRESEND) |
Authorized Official Contact | 8042257148 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dominion Medical Associates, Inc Po Box 5449 304 East Leigh Street Richmond VA 23220-0449 Ph: (804) 225-7148 | Dominion Medical Associates, Inc 304 E Leigh St Richmond VA 23219-1410 Ph: (804) 225-7148 |
NPI Number | 1396826046 |
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Provider Enumeration Date | 10/18/2006 |
Last Update Date | 05/30/2008 |
Medicare PECOS PAC ID | 6406747609 |
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Medicare Enrollment ID | O20040428001282 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396826046 | NPI | - | NPPES |
1396826046 | Other | VA | NPI GROUP NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Damien L Covington |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1316912991 PECOS PAC ID: 7618876772 Enrollment ID: I20040107000765 |
Provider Name | Richard A Jackson |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1578644290 PECOS PAC ID: 2961497094 Enrollment ID: I20040419000366 |
Provider Name | Tasha B Dickerson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1255412052 PECOS PAC ID: 3476571860 Enrollment ID: I20051103001021 |
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 | |