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Organization
LIBERTY MOUNTAIN MEDICAL GROUP
Active
Organization
LIBERTY MOUNTAIN MEDICAL GROUP
Active
Parent organization
CENTRAL VIRGINIA FAMILY PHYSICIANS, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRAL VIRGINIA FAMILY PHYSICIANS, INC.
Authorized official
KAREN L HAYNES (STAFF CREDENTIALING MANAGER)
(434) 382-1139
Entity
Organization
Contact information
Practice address
2321 WARDS RD, LYNCHBURG, VA 24502-2101
(434) 582-2273
(434) 582-1363
Mailing address
2321 WARDS RD, LYNCHBURG, VA 24502-2101
(434) 582-2273
(434) 582-1363
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/03/2015
Last updated
03/30/2016
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