MEDICARE: CENTRAL VIRGINIA FAMILY PHYSICIANS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0907130011	OTHER		MEDICARE DME
2	CC2392	OTHER	VA	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CO3658	OTHER	VA	CVFP MCARE GROUP PTAN
4	1528155892	OTHER	VA	CVFP CORPORATE NPI

General Provider Information

NPI Number	:	1366520405
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL VIRGINIA FAMILY PHYSICIANS INC

Provider Business Mailing Address
First Line	:	PO BOX 2489
Second Line	:
City	:	FOREST
State	:	VA
Zip	:	24551-6489
Country	:	US
Telephone Number	:	434-382-1139
Fax Number	:	434-525-5748

Provider Business Practice Location Address
First Line	:	4262 S AMHERST HWY
Second Line	:
City	:	MADISON HEIGHTS
State	:	VA
Zip	:	24572-5363
Country	:	US
Telephone Number	:	434-846-8421
Fax Number	:	434-846-2655

Authorized Official
Title or Position	:	STAFF CREDENTIALING MANAGER
Name	:	KAREN L HAYNES
Credential	:
Telephone Number	:	434-382-1139

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	11/28/2011

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Directions to “CENTRAL VIRGINIA FAMILY PHYSICIANS INC ” Practice Location

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