MEDICARE: DR. VIRGINIA H PRICE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	019897	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083688873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIRGINIA H PRICE MD

Provider Business Mailing Address
First Line	:	705 DALLAS HWY STE 101
Second Line	:
City	:	VILLA RICA
State	:	GA
Zip	:	30180-1243
Country	:	US
Telephone Number	:	770-459-4411
Fax Number	:	770-459-1896

Provider Business Practice Location Address
First Line	:	705 DALLAS HWY STE 101
Second Line	:
City	:	VILLA RICA
State	:	GA
Zip	:	30180-1243
Country	:	US
Telephone Number	:	770-459-4411
Fax Number	:	770-459-1896

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2006
Last Update Date	:	06/21/2010

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Directions to “ DR. VIRGINIA H PRICE MD” Practice Location

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