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NPI Code Detail

MEDICARE: ORTHOVIRGINIA INC

MEDICARE: ORTHOVIRGINIA 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
1207X00000XOrthopaedic Surgery Physician
2261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1457677221
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORTHOVIRGINIA INC
Provider Business Mailing Address
First Line : PO BOX 715868
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19171-5868
Country : US
Telephone Number : 180-491-5191
Fax Number : 804-560-9029
Provider Business Practice Location Address
First Line : 8901 THREE CHOPT RD
Second Line : SUITE D
City : RICHMOND
State : VA
Zip : 23229-4643
Country : US
Telephone Number : 804-270-1305
Fax Number : 804-273-9294
Authorized Official
Title or Position : CREDENTIALING & ENROLLMENT
Name : NICOLE PROFFITT
Credential :
Telephone Number : 804-533-2357
Provider Enumeration Date : 04/19/2010
Last Update Date : 06/02/2022

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Directions to “ORTHOVIRGINIA INC ” Practice Location

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