| Geriatric Consultants Of Fredericksburg, Llc | |
|
29 Tally Ho Dr Fredericksburg VA 22405-3308 | |
| (540) 786-8351 | |
| Not Available |
| Full Name | Geriatric Consultants Of Fredericksburg, Llc |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 29 Tally Ho Dr, Fredericksburg, Virginia |
| Authorized Official Name and Position | Frank Wayland Marks (PHYSICIAN) |
| Authorized Official Contact | 5407868351 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Geriatric Consultants Of Fredericksburg, Llc Po Box 845 Fredericksburg VA 22404-0845 Ph: (540) 371-4488 | Geriatric Consultants Of Fredericksburg, Llc 29 Tally Ho Dr Fredericksburg VA 22405-3308 Ph: (540) 786-8351 |
| NPI Number | 1336175629 |
|---|---|
| Provider Enumeration Date | 06/25/2006 |
| Last Update Date | 07/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336175629 | NPI | - | NPPES |
| 010315794 | Medicaid | VA | |
| 005872308 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 0101020614 (Virginia) | Primary |
| 363L00000X | Nurse Practitioner | 0017137109 (Virginia) | Secondary |
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