Provider Demographics
NPI:1427145663
Name:CENTRAL VIRGINIA FAMILY PHYSICIANS INC
Entity type:Organization
Organization Name:CENTRAL VIRGINIA FAMILY PHYSICIANS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:OKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-846-7374
Mailing Address - Street 1:PO BOX 2489
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-6489
Mailing Address - Country:US
Mailing Address - Phone:434-382-1125
Mailing Address - Fax:434-525-5748
Practice Address - Street 1:103 JONES STREET
Practice Address - Street 2:
Practice Address - City:APPOMATTOX
Practice Address - State:VA
Practice Address - Zip Code:24522-0607
Practice Address - Country:US
Practice Address - Phone:434-352-8235
Practice Address - Fax:434-352-5532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC07068Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
VAC04160Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER