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General NPI Number Information
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NPI Number | 1275576415
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Entity Type | Organization
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Legal Business Name | WINCHESTER FAMILY PRACTICE PC
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 1440 AMHERST ST
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City | WINCHESTER
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State | VA
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Zip | 22601-3010
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Country | US
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Telephone | 540-450-3339
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Fax | 540-450-3338
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Provider Business Mailing Address
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Address Line | 136 LINDEN DR SUITE 104
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City | WINCHESTER
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State | VA
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Zip | 22601-6900
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Country | US
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Telephone | 540-678-3588
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Fax | 540-678-9025
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | WANDA TAYLOR
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Credential |
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Telephone | 540-450-3339
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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 | VA
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