Healthcare Provider Details

I. General information

NPI: 1275767154
Provider Name (Legal Business Name): KATHLEEN C BARCIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2009
Last Update Date: 05/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 JEFFERSON HWY STE 9
LOUISA VA
23093-6563
US

IV. Provider business mailing address

115 JEFFERSON HWY STE 9
LOUISA VA
23093-6563
US

V. Phone/Fax

Practice location:
  • Phone: 540-967-9401
  • Fax: 540-967-9405
Mailing address:
  • Phone: 540-967-9401
  • Fax: 540-967-9405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101232144
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: