Healthcare Provider Details

I. General information

NPI: 1730242371
Provider Name (Legal Business Name): FIRST MED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 03/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 RIVERBEND DR STE 3
CHARLOTTESVILLE VA
22911-8695
US

IV. Provider business mailing address

125 RIVERBEND DR STE 3
CHARLOTTESVILLE VA
22911-8695
US

V. Phone/Fax

Practice location:
  • Phone: 434-984-4200
  • Fax: 434-984-6242
Mailing address:
  • Phone: 434-984-4200
  • Fax: 434-984-6242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101046855
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number0101034548
License Number StateVA

VIII. Authorized Official

Name: DR. WILLIAM G TALBOTT
Title or Position: OWNER
Credential: M.D.
Phone: 434-984-4200