Provider Demographics
NPI:1528155892
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:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-382-1139
Mailing Address - Street 1:1111 CORPORATE PARK DR
Mailing Address - Street 2:STE C
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-2286
Mailing Address - Country:US
Mailing Address - Phone:434-382-1139
Mailing Address - Fax:434-525-5748
Practice Address - Street 1:1111 CORPORATE PARK DR
Practice Address - Street 2:SUITE C
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-2286
Practice Address - Country:US
Practice Address - Phone:434-382-1139
Practice Address - Fax:434-525-5748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1528155892Medicaid
VACA2436OtherMEDICARE RAILROAD CARRIER
VACF1947OtherMEDICARE RAILROAD CARRIER
VACI3834OtherMEDICARE RAILROAD CARRIER
VACC2392OtherMEDICARE RAILROAD CARRIER
VAC03658Medicare PIN