Provider Demographics
NPI:1386716249
Name:MECHANICSVILLE MEDICAL CENTER FAMILY PHYSICIANS, P.L.L.C.
Entity type:Organization
Organization Name:MECHANICSVILLE MEDICAL CENTER FAMILY PHYSICIANS, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:EAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-746-9055
Mailing Address - Street 1:7571 COLD HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-1631
Mailing Address - Country:US
Mailing Address - Phone:804-746-9055
Mailing Address - Fax:804-746-4476
Practice Address - Street 1:7571 COLD HARBOR RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-1631
Practice Address - Country:US
Practice Address - Phone:804-746-9055
Practice Address - Fax:804-746-4476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty