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General NPI Number Information
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NPI Number | 1134228935
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Entity Type | Organization
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Legal Business Name | VILLAGE FAMILY PHYSICIANS INC
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 06/24/2010
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Provider Practice Location Address
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Address Line | 4830 RUCKER RD
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City | MONETA
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State | VA
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Zip | 24121-5281
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Country | US
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Telephone | 540-297-7181
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Fax | 540-297-6145
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Provider Business Mailing Address
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Address Line | 4830 RUCKER RD
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City | MONETA
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State | VA
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Zip | 24121-5281
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Country | US
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Telephone | 540-297-7181
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Fax | 540-297-6145
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | JANICE E LUTH
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Credential | MD
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Telephone | 540-297-7181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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