Healthcare Provider Details

I. General information

NPI: 1962469304
Provider Name (Legal Business Name): CHILDRENS ORTHOPEDIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 08/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 HIOAKS RD STE D
RICHMOND VA
23225
US

IV. Provider business mailing address

1011 HIOAKS RD STE D
RICHMOND VA
23225
US

V. Phone/Fax

Practice location:
  • Phone: 804-272-0726
  • Fax:
Mailing address:
  • Phone: 804-272-0726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101047136
License Number StateVA

VIII. Authorized Official

Name: DR. SUSAN E ATKINS
Title or Position: MD OWNER
Credential: MD
Phone: 804-272-0726