| Southside Physician Network Llc | |
|
436 Clairmont Ct Suite 105 Colonial Heights VA 23834 | |
| (804) 765-5473 | |
| (804) 765-6490 |
| Full Name | Southside Physician Network Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 436 Clairmont Ct, Colonial Heights, Virginia |
| Authorized Official Name and Position | Joanne Austin (DIRECTOR) |
| Authorized Official Contact | 8047655473 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Physician Network Llc 436 Clairmont Ct Suite 105 Colonial Heights VA 23834-1765 Ph: (804) 765-5363 | Southside Physician Network Llc 436 Clairmont Ct Suite 105 Colonial Heights VA 23834 Ph: (804) 765-5473 |
| NPI Number | 1811146194 |
|---|---|
| Provider Enumeration Date | 09/11/2008 |
| Last Update Date | 11/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811146194 | NPI | - | NPPES |
| 1811146194 | Medicaid | VA |
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