Provider Demographics
NPI:1669862215
Name:COMMUNITY FAMILY PRACTICE, P.C.
Entity Type:Organization
Organization Name:COMMUNITY FAMILY PRACTICE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:P
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-622-0453
Mailing Address - Street 1:930 MAJESTIC AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504-4055
Mailing Address - Country:US
Mailing Address - Phone:757-622-0453
Mailing Address - Fax:757-622-0455
Practice Address - Street 1:930 MAJESTIC AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504-4055
Practice Address - Country:US
Practice Address - Phone:757-622-0453
Practice Address - Fax:757-622-0455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231062207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty