| Riverside Fishing Bay Family Practice | |
|
16681 General Puller Hwy Deltaville VA 23043-2006 | |
| (804) 776-8000 | |
| (804) 776-6211 |
| Full Name | Riverside Fishing Bay Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 16681 General Puller Hwy, Deltaville, Virginia |
| Authorized Official Name and Position | James Leesnick (VICE PRESIDENT) |
| Authorized Official Contact | 7575944006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverside Fishing Bay Family Practice 856 J Clyde Morris Blvd Suite A Newport News VA 23601-1318 Ph: (757) 594-4006 | Riverside Fishing Bay Family Practice 16681 General Puller Hwy Deltaville VA 23043-2006 Ph: (804) 776-8000 |
| NPI Number | 1053339762 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 10/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053339762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |