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Organization
WILEY J LATHAM MD AND BERNICE G LATHAM MD PARTNERS
Active
Organization
WILEY J LATHAM MD AND BERNICE G LATHAM MD PARTNERS
Active
Other names
Latham and Latham MDs
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILEY JACOB LATHAM III MD (PARTNER)
(804) 780-3008
Entity
Organization
Contact information
Practice address
505 WEST LEIGH ST, SUITE 301, RICHMOND, VA 23220
(804) 780-3008
(804) 780-3014
Mailing address
PO BOX 15483, RICHMOND, VA 23227-0000
(804) 780-3008
(804) 780-3014
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101023261
VA
207RG0100X
Gastroenterology Physician
0101023313
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5671051
—
VA
05
—
6071066
—
VA
Enumeration date
08/31/2006
Last updated
10/01/2012
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