| Ivy Family Medicine, Plc | |
|
2 Boars Head Pl Suite 110 Charlottesville VA 22903-4611 | |
| (434) 466-8363 | |
| Not Available |
| Full Name | Ivy Family Medicine, Plc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2 Boars Head Pl, Charlottesville, Virginia |
| Authorized Official Name and Position | Lily Wise Hargrove (OWNER) |
| Authorized Official Contact | 4344668363 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivy Family Medicine, Plc 516 Rookwood Pl Charlottesville VA 22903-4734 Ph: (434) 466-8363 | Ivy Family Medicine, Plc 2 Boars Head Pl Suite 110 Charlottesville VA 22903-4611 Ph: (434) 466-8363 |
| NPI Number | 1073818787 |
|---|---|
| Provider Enumeration Date | 01/12/2011 |
| Last Update Date | 04/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073818787 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0101057199 (Virginia) | Primary |
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