| |
3311 Church Rd Suite 100 Richmond VA 23233 | |
(804) 965-9087 | |
(804) 965-0721 |
Full Name | |
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Speciality | Family Medicine |
Location | 3311 Church Rd, Richmond, Virginia |
Authorized Official Name and Position | George Odell Butler (DIRECTOR OF CORP RESPONSIBILITY) |
Authorized Official Contact | 8042810271 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3311 Church Rd Suite 100 Richmond VA 23233-1814 Ph: (804) 965-9087 | 3311 Church Rd Suite 100 Richmond VA 23233 Ph: (804) 965-9087 |
NPI Number | 1528091808 |
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Provider Enumeration Date | 07/09/2006 |
Last Update Date | 07/27/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528091808 | NPI | - | NPPES |
CA6615 | Other | VA | RAILROAD MEDICARE |
CC4370 | Other | VA | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Mary Brantley Holmes Msn Whnp-bc Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8955 Wishart Rd, Richmond, VA 23229 Phone: 804-928-5596 | |
Independent Associates Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7605 Forest Ave, Ste 211, Richmond, VA 23229 Phone: 804-282-3114 Fax: 804-285-9723 | |