Provider Demographics
NPI:1407564842
Name:TROUBLESOME CREEK MEDICINE
Entity Type:Organization
Organization Name:TROUBLESOME CREEK MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HUCKS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:434-983-2722
Mailing Address - Street 1:799 TROUBLESOME CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BUCKINGHAM
Mailing Address - State:VA
Mailing Address - Zip Code:23921-3314
Mailing Address - Country:US
Mailing Address - Phone:434-983-2722
Mailing Address - Fax:434-300-5177
Practice Address - Street 1:799 TROUBLESOME CREEK RD
Practice Address - Street 2:
Practice Address - City:BUCKINGHAM
Practice Address - State:VA
Practice Address - Zip Code:23921-3314
Practice Address - Country:US
Practice Address - Phone:434-983-2722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty