Provider Demographics
NPI:1134228935
Name:VILLAGE FAMILY PHYSICIANS INC
Entity type:Organization
Organization Name:VILLAGE FAMILY PHYSICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:E
Authorized Official - Last Name:LUTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-297-7181
Mailing Address - Street 1:4830 RUCKER RD
Mailing Address - Street 2:
Mailing Address - City:MONETA
Mailing Address - State:VA
Mailing Address - Zip Code:24121-5281
Mailing Address - Country:US
Mailing Address - Phone:540-297-7181
Mailing Address - Fax:540-297-6145
Practice Address - Street 1:4830 RUCKER RD
Practice Address - Street 2:
Practice Address - City:MONETA
Practice Address - State:VA
Practice Address - Zip Code:24121-5281
Practice Address - Country:US
Practice Address - Phone:540-297-7181
Practice Address - Fax:540-297-6145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CL1722Medicare PIN
C02032Medicare PIN