Provider Demographics
NPI:1518150739
Name:OB HOSPITALIST INC
Entity Type:Organization
Organization Name:OB HOSPITALIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNNAVANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-741-0440
Mailing Address - Street 1:PO BOX 7650
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-0150
Mailing Address - Country:US
Mailing Address - Phone:804-507-1644
Mailing Address - Fax:804-507-0116
Practice Address - Street 1:1603 SKIPWITH RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23229-5253
Practice Address - Country:US
Practice Address - Phone:804-507-1644
Practice Address - Fax:804-507-0116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVV4956AMedicare PIN