Provider Demographics
NPI:1538149349
Name:FOX AND BRANTLEY INTERNAL MEDICINE PLC
Entity type:Organization
Organization Name:FOX AND BRANTLEY INTERNAL MEDICINE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-244-5684
Mailing Address - Street 1:916 E HIGH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-4852
Mailing Address - Country:US
Mailing Address - Phone:434-244-5684
Mailing Address - Fax:434-244-5685
Practice Address - Street 1:916 E HIGH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-4852
Practice Address - Country:US
Practice Address - Phone:434-244-5684
Practice Address - Fax:434-244-5685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADA8399Medicare PIN
VAC08882Medicare PIN