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General NPI Number Information
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NPI Number | 1023106390
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Entity Type | Organization
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Legal Business Name | INDEPENDENT ASSOCIATES PC
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 06/20/2011
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Provider Practice Location Address
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Address Line | 7605 FOREST AVE STE 211
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City | RICHMOND
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State | VA
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Zip | 23229-4938
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Country | US
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Telephone | 804-282-3114
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Fax | 804-285-9723
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Provider Business Mailing Address
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Address Line | 7605 FOREST AVE STE 211
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City | RICHMOND
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State | VA
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Zip | 23229-4938
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Country | US
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Telephone | 804-282-3114
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Fax | 804-285-9723
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. RICHARD GARDNER MITCHELL
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Credential | M.D.
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Telephone | 804-282-3114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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