| Mobjack Medical Group | |
|
6506 Main St Gloucester VA 23061-6103 | |
| (804) 684-5043 | |
| Not Available |
| Full Name | Mobjack Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 6506 Main St, Gloucester, Virginia |
| Authorized Official Name and Position | Francis Thornton West (PRESIDENT) |
| Authorized Official Contact | 8046845043 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobjack Medical Group 6506 Main St Gloucester VA 23061-6103 Ph: (804) 684-5043 | Mobjack Medical Group 6506 Main St Gloucester VA 23061-6103 Ph: (804) 684-5043 |
| NPI Number | 1588903736 |
|---|---|
| Provider Enumeration Date | 02/07/2013 |
| Last Update Date | 02/07/2013 |
| Medicare PECOS PAC ID | 3072751171 |
|---|---|
| Medicare Enrollment ID | O20130531000347 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588903736 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101242168 (Virginia) | Primary |
| 207R00000X | Internal Medicine | 0101242319 (Virginia) | Secondary |
| Provider Name | Francis Thorton West |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235226176 PECOS PAC ID: 2567559644 Enrollment ID: I20071106000751 |
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