Healthcare Provider Details

I. General information

NPI: 1427145663
Provider Name (Legal Business Name): CENTRAL VIRGINIA FAMILY PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 JONES STREET
APPOMATTOX VA
24522-0607
US

IV. Provider business mailing address

PO BOX 2489
FOREST VA
24551-6489
US

V. Phone/Fax

Practice location:
  • Phone: 434-352-8235
  • Fax: 434-352-5532
Mailing address:
  • Phone: 434-382-1125
  • Fax: 434-525-5748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL A OKIN
Title or Position: PRESIDENT
Credential: MD
Phone: 434-846-7374