Organization Name: | WIGGINGTON ROAD FAMILY PRACTICE INC |
NPI Number: | 1942396908 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALAN M. PODOSEH (MEDICAL DOCTOR) |
Mailing Address: | 113 Wiggington Road Lynchburg |
State: | VA US |
Postal Code: | 24502 |
Phone Number: | 4343857578 |
Fax Number: | 4343859756 |
NPI Enumeration Date: | 10/05/2006 |
NPI Last Update Date: | 06/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |