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General NPI Number Information
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NPI Number | 1669858635
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Entity Type | Organization
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Legal Business Name | LEGACY HEALTH MANAGEMENT SOLUTIONS
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Dates
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Enumeration Date | 07/31/2015
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Last Update Date | 07/31/2015
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Provider Practice Location Address
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Address Line | 5206 MARKEL RD SUITE 102
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City | RICHMOND
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State | VA
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Zip | 23230-3044
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Country | US
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Telephone | 804-564-2746
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Fax |
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Provider Business Mailing Address
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Address Line | 5206 MARKEL RD SUITE 102
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City | RICHMOND
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State | VA
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Zip | 23230-3044
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Country | US
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Telephone | 804-564-2746
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES THOMPSON
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Credential | M.D.
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Telephone | 804-564-2746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 0101246355
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 0101246355
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101246355
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License Number State | VA
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