Provider Demographics
NPI:1235226176
Name:WEST, FRANCIS THORNTON III (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:THORNTON
Last Name:WEST
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 683
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061
Mailing Address - Country:US
Mailing Address - Phone:804-684-5043
Mailing Address - Fax:804-684-5392
Practice Address - Street 1:6506 MAIN STREET
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061
Practice Address - Country:US
Practice Address - Phone:804-684-5043
Practice Address - Fax:804-684-5392
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101242168207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1235226176Medicaid
VA1235226176Medicaid
VAP00454411Medicare PIN