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General NPI Number Information
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NPI Number | 1285903518
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Entity Type | Organization
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Legal Business Name | UROLOGY SPECIALISTS OF VIRGINIA, P.C.
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Dates
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Enumeration Date | 12/15/2011
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Last Update Date | 01/02/2019
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Provider Practice Location Address
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Address Line | 8700 STONY POINT PKWY
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City | RICHMOND
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State | VA
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Zip | 23235-1962
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Country | US
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Telephone | 804-323-0226
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8310
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City | ROANOKE
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State | VA
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Zip | 24014-0310
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EUGENE PARK
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Credential | M.D.
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Telephone | 804-200-7066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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