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General NPI Number Information
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NPI Number | 1669862215
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Entity Type | Organization
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Legal Business Name | COMMUNITY FAMILY PRACTICE, P.C.
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Dates
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Enumeration Date | 02/03/2015
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 930 MAJESTIC AVE SUITE 210
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City | NORFOLK
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State | VA
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Zip | 23504-4055
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Country | US
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Telephone | 757-622-0453
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Fax | 757-622-0455
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Provider Business Mailing Address
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Address Line | 930 MAJESTIC AVE SUITE 210
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City | NORFOLK
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State | VA
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Zip | 23504-4055
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Country | US
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Telephone | 757-622-0453
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Fax | 757-622-0455
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Authorized Official
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Title or Position | SECRETARY/PRESIDENT/OWNER
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Name | DR. ALEX P TAYLOR
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Credential | M.D.
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Telephone | 757-622-0453
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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 | 0101231062
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License Number State | VA
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