Healthcare Provider Details

I. General information

NPI: 1851616528
Provider Name (Legal Business Name): PL PHYSICIANS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2010
Last Update Date: 04/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9671 COURTHOUSE RD SUITE 113
SPOTSYLVANIA VA
22553
US

IV. Provider business mailing address

9671 COURTHOUSE RD SUITE 113
SPOTSYLVANIA VA
22553
US

V. Phone/Fax

Practice location:
  • Phone: 540-371-4488
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ASHLEIGH A RAUBENOLT
Title or Position: CREDENTIALING
Credential:
Phone: 540-371-4488