Healthcare Provider Details

I. General information

NPI: 1578257655
Provider Name (Legal Business Name): INSPIRE PRIMARY CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4823 S LABURNUM AVE STE B
RICHMOND VA
23231-2713
US

IV. Provider business mailing address

6751 GILLS GATE CT
CHESTERFIELD VA
23832-6005
US

V. Phone/Fax

Practice location:
  • Phone: 804-597-9192
  • Fax: 888-571-6303
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CARLA LYNETTE KING
Title or Position: PEDIATRICIAN/CO-OWNER
Credential: MD
Phone: 804-370-6660