Provider Demographics
NPI:1770508442
Name:MCV ASSOCIATED PHYSICIANS
Entity type:Organization
Organization Name:MCV ASSOCIATED PHYSICIANS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR MEDICAL STAFF SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOUCHENS
Authorized Official - Suffix:
Authorized Official - Credentials:CPMSM CPCS
Authorized Official - Phone:804-828-8707
Mailing Address - Street 1:1250 E MARSHALL STREET
Mailing Address - Street 2:ANESTHESIOLOGY C03042
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-0510
Mailing Address - Country:US
Mailing Address - Phone:804-828-8707
Mailing Address - Fax:807-828-8765
Practice Address - Street 1:1250 E MARSHALL STREET
Practice Address - Street 2:ANESTHESIOLOGY C03042
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-0510
Practice Address - Country:US
Practice Address - Phone:804-828-8707
Practice Address - Fax:807-828-8765
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCV ASSOCIATED PHYSICIANS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-13
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction MedicineGroup - Multi-Specialty
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care MedicineGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5734371Medicaid
VA5734371Medicaid