# CHAN M PARK FAMILY PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164243986
- **Authorized official:** CURTSHER THOBBS (OFFICE MANAGER)
- **Authorized official phone:** (276) 956-2047

## Contact information

- **Practice address:** 6460 GREENSBORO RD, RIDGEWAY, VA 24148-3478
- **Practice address phone:** (276) 956-2047
- **Practice address fax:** (276) 956-1637
- **Mailing address:** 6460 GREENSBORO RD, RIDGEWAY, VA 24148-3478
- **Mailing address phone:** (276) 956-2047
- **Mailing address fax:** (276) 956-1637

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/23/2024
- **Last updated:** 11/12/2025