Healthcare Provider Details

I. General information

NPI: 1548206071
Provider Name (Legal Business Name): CENTRAL VIRGINIA FAMILY PHYSICIANS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 06/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 JONES ST
APPOMATTOX VA
24522-9830
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: 434-382-1139
  • 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: MATTHEW A JOHNSON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 434-846-7374