Olde Towne Family Practice
Family Medicine in Portsmouth, VA. Organization (NPI-2).
NPI number1184861973
StatusActive
Last updated in NPPESJan 15, 2009
Details
- NPI
- 1184861973
- Entity type
- Organization (NPI-2)
- Legal business name
- Olde Towne Family Practice
- Organization subpart
- No
- Enumeration date
- Jan 15, 2009
- Last updated
- Jan 15, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
640 North StPortsmouth, VA 23704-2415
Phone 757-397-1246 · Fax 757-397-0089
Mailing address
640 North StPortsmouth, VA 23704-2415
Phone 757-397-1246 · Fax 757-397-0089
Authorized official
Patricia Butler
Billing Manager
7576380085
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