# ALLIANCE FAMILY PRACTICE, P.C.

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

## Provider details

- **NPI number:** 1174714141
- **Authorized official:** DR. ZELDA WEST JOHNSON M.D. (FAMILY PRACTICE PROVIDER)
- **Authorized official phone:** (804) 862-2878

## Contact information

- **Practice address:** 40 LIBERTY ST, PETERSBURG, VA 23803-5021
- **Practice address phone:** (804) 862-2878
- **Practice address fax:** (804) 862-2879
- **Mailing address:** 40 LIBERTY ST, PETERSBURG, VA 23803-5021
- **Mailing address phone:** (804) 862-2878
- **Mailing address fax:** (804) 862-2879

## Taxonomy

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

## Other

- **Enumeration date:** 08/06/2007
- **Last updated:** 06/11/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 302200 | ANTHEM BC OF VIRGINIA | VA |