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General NPI Number Information
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NPI Number | 1548206071
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Entity Type | Organization
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Legal Business Name | CENTRAL VIRGINIA FAMILY PHYSICIANS, INC
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 131 JONES ST
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City | APPOMATTOX
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State | VA
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Zip | 24522-9830
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Country | US
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Telephone | 434-352-8235
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Fax | 434-352-5532
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Provider Business Mailing Address
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Address Line | PO BOX 2489
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City | FOREST
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State | VA
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Zip | 24551-6489
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Country | US
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Telephone | 434-382-1139
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Fax | 434-525-5748
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW A JOHNSON
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Credential | M.D.
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Telephone | 434-846-7374
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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 |
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