NPI Code Details Logo

NPI 1225110737

NPI 1225110737 : CENTRAL VIRGINIA FAMILY PHYSICIANS INC : MADISON HEIGHTS, VA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1225110737
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    CENTRAL VIRGINIA FAMILY PHYSICIANS INC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    10/20/2006
-----------------------------------------------------
    Last Update Date     |    06/19/2014
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    200 AMELON SQ 
-----------------------------------------------------
    City                 |    MADISON HEIGHTS
-----------------------------------------------------
    State                |    VA
-----------------------------------------------------
    Zip                  |    24572-5981
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    434-929-1095
-----------------------------------------------------
    Fax                  |    434-929-1098
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    PO BOX 2489 
-----------------------------------------------------
    City                 |    FOREST
-----------------------------------------------------
    State                |    VA
-----------------------------------------------------
    Zip                  |    24551-6489
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    434-382-1139
-----------------------------------------------------
    Fax                  |    434-525-5748
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    STAFF CREDENTIALING MANAGER
-----------------------------------------------------
    Name                 |     KAREN L HAYNES 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    434-382-1139
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207Q00000X
-----------------------------------------------------
    Taxonomy Name        |    Family Medicine Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.