Provider Demographics
NPI:1831580646
Name:THE ORTHOPAEDIC INSTITUTE OF VIRGINIA PLLC
Entity type:Organization
Organization Name:THE ORTHOPAEDIC INSTITUTE OF VIRGINIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:WILSON
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-288-2830
Mailing Address - Street 1:8814 FARGO RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4647
Mailing Address - Country:US
Mailing Address - Phone:804-288-2830
Mailing Address - Fax:804-288-2850
Practice Address - Street 1:1501 MAPLE AVE
Practice Address - Street 2:NW MOB, SUITE 200
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2553
Practice Address - Country:US
Practice Address - Phone:804-285-2300
Practice Address - Fax:804-285-8420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty