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General NPI Number Information
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NPI Number | 1568441897
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Entity Type | Organization
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Legal Business Name | DERMATOLOGIC SURGERY OF CENTRAL VIRGINIA PLC
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Dates
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Enumeration Date | 01/13/2006
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Last Update Date | 05/12/2015
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Provider Practice Location Address
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Address Line | 902 E JEFFERSON ST SUITE 201
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-5397
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Country | US
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Telephone | 434-979-7700
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Fax | 434-979-7715
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Provider Business Mailing Address
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Address Line | PO BOX 826696
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City | PHILADELPHIA
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State | PA
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Zip | 19182-6696
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Country | US
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Telephone | 434-979-7700
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Fax | 434-979-7715
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Authorized Official
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Title or Position | OWNER
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Name | JOHN D HENDRIX JR.
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Credential | MD
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Telephone | 434-979-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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