Provider Demographics
NPI:1942396908
Name:WIGGINGTON ROAD FAMILY PRACTICE INC
Entity Type:Organization
Organization Name:WIGGINGTON ROAD FAMILY PRACTICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PODOSEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-385-7578
Mailing Address - Street 1:113 WIGGINGTON ROAD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502
Mailing Address - Country:US
Mailing Address - Phone:434-385-7578
Mailing Address - Fax:434-385-9756
Practice Address - Street 1:113 WIGGINGTON ROAD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502
Practice Address - Country:US
Practice Address - Phone:434-385-7578
Practice Address - Fax:434-385-9756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1205921210OtherINDIVIDUAL NPI CHRISTIAN
VA5642876Medicaid
VA249893OtherANTHEM BCBS CHRISTIAN
VA012828OtherANTHEM FOR ALAN PODOSEK
VA1205851581OtherINDIV NPI ALAN PODOSEK,MD
VA1356366645OtherINDIV NPI HARB RANK, MD
VA010386250Medicaid
VA214335OtherANTHEM FOR HARB RANK, MD
VA5674808Medicaid
VA1205851581OtherINDIV NPI ALAN PODOSEK,MD
VA5674808Medicaid
VA5642876Medicaid