Provider Demographics
NPI:1407936941
Name:CENTRAL VIRGINIA FAMILY PHYSICIANS, INC
Entity Type:Organization
Organization Name:CENTRAL VIRGINIA FAMILY PHYSICIANS, INC
Other - Org Name:RUSTBURG FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:EPPES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-525-6964
Mailing Address - Street 1:PO BOX 2489
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-6489
Mailing Address - Country:US
Mailing Address - Phone:434-382-1139
Mailing Address - Fax:434-525-5748
Practice Address - Street 1:925 VILLAGE HWY
Practice Address - Street 2:
Practice Address - City:RUSTBURG
Practice Address - State:VA
Practice Address - Zip Code:24588-4591
Practice Address - Country:US
Practice Address - Phone:434-332-7367
Practice Address - Fax:434-332-1757
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL VIRGINIA FAMILY PHYSICIANS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-17
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1528155892OtherCVFP CORPORATE NPI
VACA2436OtherMEDICARE RAILROAD
VAC03658OtherCVFP MCARE GROUP PTAN
VACI3834OtherMEDICARE RAILROAD
VA0907130004Medicare NSC