| NPI | 1063516672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | P. FREDERICK DUCKWORTH Managing Physician 804-285-8206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2025-10-08 |