Provider Demographics
NPI:1073696241
Name:CHILDREN'S UROLOGY OF VIRGINIA
Entity Type:Organization
Organization Name:CHILDREN'S UROLOGY OF VIRGINIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BOYD
Authorized Official - Middle Name:
Authorized Official - Last Name:WINSLOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-272-2411
Mailing Address - Street 1:8700 STONY POINT PKWY
Mailing Address - Street 2:STE 250
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-1962
Mailing Address - Country:US
Mailing Address - Phone:804-272-2411
Mailing Address - Fax:804-272-3370
Practice Address - Street 1:8700 STONY POINT PKWY
Practice Address - Street 2:STE 250
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1962
Practice Address - Country:US
Practice Address - Phone:804-272-2411
Practice Address - Fax:804-272-3370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty