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General NPI Number Information
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NPI Number | 1194867549
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Entity Type | Individual
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Provider Name | BRYAN SCOTT URQUHART PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 12/10/2012
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Provider Practice Location Address
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Address Line | 10711 SPOTSYLVANIA AVE
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City | FREDERICKSBURG
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State | VA
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Zip | 22408-2674
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Country | US
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Telephone | 540-891-8499
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Fax | 540-891-8662
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Provider Business Mailing Address
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Address Line | 10711 SPOTSYLVANIA AVE
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City | FREDERICKSBURG
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State | VA
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Zip | 22408-2674
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Country | US
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Telephone | 540-891-8499
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Fax | 540-891-8662
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0110840479
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License Number State | VA
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