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General NPI Number Information
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NPI Number | 1578668430
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Entity Type | Organization
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Legal Business Name | POWHATAN FAMILY PHYSICIANS, LTD
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 03/08/2010
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Provider Practice Location Address
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Address Line | 2615 ANDERSON HWY SUITE A
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City | POWHATAN
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State | VA
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Zip | 23139-7400
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Country | US
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Telephone | 804-794-1555
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Fax | 804-403-0334
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Provider Business Mailing Address
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Address Line | 2615 ANDERSON HWY SUITE A
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City | POWHATAN
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State | VA
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Zip | 23139-7400
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Country | US
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Telephone | 804-794-1555
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Fax | 804-403-0334
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SANDY DUNCAN
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Credential |
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Telephone | 804-794-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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