Provider Demographics
NPI:1437134384
Name:PRICE, WILLIAM R (NP)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:PRICE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 ATHERHOLT RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-2148
Mailing Address - Country:US
Mailing Address - Phone:434-200-5252
Mailing Address - Fax:434-847-3645
Practice Address - Street 1:2410 ATHERHOLT RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-2148
Practice Address - Country:US
Practice Address - Phone:434-200-5252
Practice Address - Fax:434-847-3645
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024164907363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010169160Medicaid
VAQ48746Medicare UPIN
VA010169160Medicaid