# OLDE TOWNE FAMILY PRACTICE

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

## Provider details

- **NPI number:** 1184861973
- **Authorized official:** PATRICIA BUTLER (BILLING MANAGER)
- **Authorized official phone:** (757) 638-0085

## Contact information

- **Practice address:** 640 NORTH ST, PORTSMOUTH, VA 23704-2415
- **Practice address phone:** (757) 397-1246
- **Practice address fax:** (757) 397-0089
- **Mailing address:** 640 NORTH ST, PORTSMOUTH, VA 23704-2415
- **Mailing address phone:** (757) 397-1246
- **Mailing address fax:** (757) 397-0089

## Taxonomy

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

## Other

- **Enumeration date:** 01/15/2009
- **Last updated:** 01/15/2009