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General NPI Number Information
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NPI Number | 1154323988
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Entity Type | Organization
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Legal Business Name | CENTRAL VIRGINIA SURGI-CENTER LP
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 1500 DIXON ST STE 101, MAILBOX 1
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-7231
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Country | US
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Telephone | 540-371-5349
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Fax | 540-373-1745
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Provider Business Mailing Address
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Address Line | 1500 DIXON ST STE 101, MAILBOX 1
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-7231
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Country | US
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Telephone | 540-371-5349
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Fax | 540-373-1745
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Authorized Official
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Title or Position | OFFICER/AO
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Name | KRISTEN OCONNOR
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Credential |
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Telephone | 615-376-7315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | OH 674
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License Number State | VA
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