| Old Hampton Family Medical Associates, P.c. | |
|
26 Wine St Hampton VA 23669-3584 | |
| (757) 728-1100 | |
| (757) 728-0870 |
| Full Name | Old Hampton Family Medical Associates, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 26 Wine St, Hampton, Virginia |
| Authorized Official Name and Position | Ann Shaw (OFFICE MANAGER) |
| Authorized Official Contact | 7577281100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Old Hampton Family Medical Associates, P.c. 26 Wine St Hampton VA 23669-3584 Ph: (757) 728-1100 | Old Hampton Family Medical Associates, P.c. 26 Wine St Hampton VA 23669-3584 Ph: (757) 728-1100 |
| NPI Number | 1912035916 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 02/11/2010 |
| Medicare PECOS PAC ID | 1052588282 |
|---|---|
| Medicare Enrollment ID | O20120111000611 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912035916 | NPI | - | NPPES |
| 5637341 | Medicaid | VA | |
| 005114 | Other | VA | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Leo C Bowers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508966573 PECOS PAC ID: 8022285261 Enrollment ID: I20120111000656 |
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