| NPI | 1396826046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD ALLEN JACKSON Presend 804-225-7148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2008-05-30 |