| Executive Health Group | |
|
7101 Jahnke Rd Suite 550-a Richmond VA 23225-4017 | |
| (804) 560-3295 | |
| (804) 560-9577 |
| Full Name | Executive Health Group |
|---|---|
| Speciality | Family Medicine |
| Location | 7101 Jahnke Rd, Richmond, Virginia |
| Authorized Official Name and Position | John Rand Baggesen (PRESIDENT & CEO) |
| Authorized Official Contact | 8043385157 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Executive Health Group 7101 Jahnke Rd Suite 550-a Richmond VA 23225-4017 Ph: (804) 560-3295 | Executive Health Group 7101 Jahnke Rd Suite 550-a Richmond VA 23225-4017 Ph: (804) 560-3295 |
| NPI Number | 1033497649 |
|---|---|
| Provider Enumeration Date | 07/31/2011 |
| Last Update Date | 07/31/2011 |
| Medicare PECOS PAC ID | 6800060351 |
|---|---|
| Medicare Enrollment ID | O20111117000548 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033497649 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101057853 (Virginia) | Primary |
| Provider Name | John R Baggesen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417932641 PECOS PAC ID: 4789678376 Enrollment ID: I20040414001553 |
| Provider Name | Christine D Allan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376582213 PECOS PAC ID: 5496743148 Enrollment ID: I20040503001049 |
| Provider Name | Brian S Neely |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760479257 PECOS PAC ID: 1951407014 Enrollment ID: I20110510000457 |
| Provider Name | Hayden Merrill Pasco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578724274 PECOS PAC ID: 8527232727 Enrollment ID: I20111128000857 |
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