Basic Information
| Provider Information | |||||||||
| NPI: | 1427145663 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CENTRAL VIRGINIA FAMILY PHYSICIANS INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | APPOMATTOX FAMILY PRACTICE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2489 | ||||||||
| Address2: | |||||||||
| City: | FOREST | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245516489 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4343821125 | ||||||||
| FaxNumber: | 4345255748 | ||||||||
| Practice Location | |||||||||
| Address1: | 103 JONES STREET | ||||||||
| Address2: | |||||||||
| City: | APPOMATTOX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245220607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4343528235 | ||||||||
| FaxNumber: | 4343525532 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | OKIN | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4348467374 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.