Healthcare Provider Details

I. General information

NPI: 1346222916
Provider Name (Legal Business Name): RICHARD F STOWERS JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 03/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 MEMORIAL AVE SUITE 10
LYNCHBURG VA
24501-2661
US

IV. Provider business mailing address

2323 MEMORIAL AVE SUITE 10
LYNCHBURG VA
24501-2661
US

V. Phone/Fax

Practice location:
  • Phone: 434-200-5200
  • Fax: 434-200-1641
Mailing address:
  • Phone: 434-200-5200
  • Fax: 434-200-1641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101032436
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: